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Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T cruzi/HIV Co-infected Patients

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dc.contributor.author Castro-Sesquen, Yagahira E.
dc.contributor.author Gilman, Robert H.
dc.contributor.author Mejia, Carolina
dc.contributor.author Clark, Daniel E.
dc.contributor.author Choi, Jeong
dc.contributor.author Reimer-McAtee, Melissa J.
dc.contributor.author Castro, Rosario
dc.contributor.author Valencia-Ayala, Edward
dc.contributor.author Flores, Jorge
dc.contributor.author Bowman, Natalie
dc.contributor.author Castillo-Neyra, Ricardo
dc.contributor.author Torrico, Faustino
dc.contributor.author Liotta, Lance
dc.contributor.author Bern, Caryn
dc.contributor.author Luchini, Alessandra
dc.date.accessioned 2019-02-06T14:45:11Z
dc.date.available 2019-02-06T14:45:11Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5041
dc.description.abstract BACKGROUND: Early diagnosis of reactivated Chagas disease in HIV patients could be lifesaving. In Latin America, the diagnosis is made by microscopical detection of the T. cruzi parasite in the blood; a diagnostic test that lacks sensitivity. This study evaluates if levels of T. cruzi antigens in urine, determined by Chunap (Chagas urine nanoparticle test), are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. METHODOLOGY/PRINCIPAL FINDINGS: T. cruzi antigens in urine of HIV patients (N = 55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. Reactivation of Chagas disease was defined by the observation of parasites in blood by microscopy. Parasitemia levels in patients with serology positive for Chagas disease were classified as follows: High parasitemia or reactivation of Chagas disease (detectable parasitemia by microscopy), moderate parasitemia (undetectable by microscopy but detectable by qPCR), and negative parasitemia (undetectable by microscopy and qPCR). The percentage of positive results detected by Chunap was: 100% (7/7) in cases of reactivation, 91.7% (11/12) in cases of moderate parasitemia, and 41.7% (5/12) in cases of negative parasitemia. Chunap specificity was found to be 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels and urine T. cruzi antigen concentrations (p<0.001). A cut-off of > 105 pg was chosen to determine patients with reactivation of Chagas disease (7/7). Antigenuria levels were 36.08 times (95% CI: 7.28 to 64.88) higher in patients with CD4+ lymphocyte counts below 200/mL (p = 0.016). No significant differences were found in HIV loads and CD8+ lymphocyte counts. CONCLUSION: Chunap shows potential for early detection of Chagas reactivation. With appropriate adaptation, this diagnostic test can be used to monitor Chagas disease status in T. cruzi/HIV co-infected patients. en_US
dc.language.iso eng
dc.publisher PLoS
dc.relation.ispartof urn:issn:1935-2735
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Antigens, Protozoan/urine en_US
dc.subject Case-Control Studies en_US
dc.subject CD8-Positive T-Lymphocytes en_US
dc.subject Chagas Disease/complications/diagnosis/parasitology/urine en_US
dc.subject Coinfection/diagnosis/immunology/parasitology/urine en_US
dc.subject Diagnostic Tests, Routine/instrumentation/methods en_US
dc.subject Early Diagnosis en_US
dc.subject Female en_US
dc.subject HIV Infections/complications/urine en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Middle Aged en_US
dc.subject Nanoparticles/chemistry en_US
dc.subject Parasitemia/diagnosis/immunology/parasitology/urine en_US
dc.subject Trypanosoma cruzi/genetics/immunology/isolation & purification en_US
dc.subject Young Adult en_US
dc.title Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T cruzi/HIV Co-infected Patients en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pntd.0004407
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06


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