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Seminaris

"Chagas disease and HIV infection"

03/02/2010
14.00 - 15.00 h
Aula 2, Facultat de Medicina, Hospital Clínic

The prevalence of Chagas disease and HIV infection in endemic areas suggest that the reported cases of reactivation of Chagas disease in HIV infected patients are underestimated. This reactivation seems to occur in about 20% of patients with T. cruzi/HIV co-infection  as severe meningoencephalitis, myocarditis, meningoencephalitis associated with myocarditis, or less severe skin lesions or other organs involvement, and even as olygosymptomatic cases, as registered in prospective studies. The reactivation has been associated with less than 200 TCD4 cell/mm3 in the peripheral blood and lack of effective antiretroviral therapy. A higher T. cruzi parasitemia has also been reported in patients who reactivated in comparison to co-infected patients with lower parasitemia, in five years of follow-up. The screening of both infections should be performed in patients with Chagas disease or HIV infection as well in every HIV patient with meningoencephalitis or myocarditis or skin lesions that had any epidemiological record suggestive of Chagas disease. Based on prospective studies it is important to monitor the parasitemia in patients with T. cruzi/HIV coinfection. The validation of a Real Time PCR method for this purpose and the support of an “International network of Attention and Studies on T. cruzi/HIV infection and other immunosupression” is a very important step towards increasing our knowledge about this disease and creating new mechanisms to intervene in the evolution of Chagas disease in immunosuppressed hosts and improve their health care.

Dr. M.A.Yasuda Shikanai, Infectious and Parasitic Diseases Department,
Facultade de Medicina, University of São Paulo, São Paulo (Brazil)

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