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HIV and Chagas Disease: An Evaluation of the Use of Real-Time Quantitative Polymerase Chain Reaction to Measure Levels of Trypanosoma cruzi Parasitemia in HIV Patients in Cochabamba, Bolivia

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dc.contributor.author Reimer-McAtee, Melissa J.
dc.contributor.author Mejia, Carolina
dc.contributor.author Clark, Taryn
dc.contributor.author Terle, Jules
dc.contributor.author Pajuelo Travezaño, Monica Jhenny
dc.contributor.author Cabeza, Jeanne
dc.contributor.author Lora, Meredith H.
dc.contributor.author Valencia, Edward
dc.contributor.author Castro, Rosario
dc.contributor.author Lozano, Daniel
dc.contributor.author Bern, Caryn
dc.contributor.author Torrico, Faustino
dc.contributor.author Gilman, Robert Hugh
dc.date.accessioned 2021-10-04T23:00:58Z
dc.date.available 2021-10-04T23:00:58Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9836
dc.description.abstract This cross-sectional study evaluated epidemiologic characteristics of persons living with HIV (PWH) coinfected with Trypanosoma cruzi in Cochabamba, Bolivia, and estimated T. cruzi parasitemia by real-time quantitative polymerase chain reaction (qPCR) in patients with and without evidence of reactivation by direct microscopy. Thirty-two of the 116 HIV patients evaluated had positive serology for T. cruzi indicative of chronic Chagas disease (27.6%). Sixteen of the 32 (50%) patients with positive serology were positive by quantitative polymerase chain reaction (qPCR), and four of the 32 (12.5%) were positive by direct microscopy. The median parasite load by qPCR in those with CD4+ < 200 was 168 parasites/mL (73-9951) compared with 28.5 parasites/mL (15-1,528) in those with CD4+ ≥ 200 (P = 0.89). There was a significant inverse relationship between the degree of parasitemia estimated by qPCR from blood clot and CD4+ count on the logarithmic scale (rsBC= -0.70, P = 0.007). The correlation between T. cruzi estimated by qPCR+ blood clot and HIV viral load was statistically significant with rsBC = 0.61, P = 0.047. Given the significant mortality of PWH and Chagas reactivation and that 57% of our patients with CD4+ counts < 200 cells/mm3 showed evidence of reactivation, we propose that screening for chronic Chagas disease be considered in PWH in regions endemic for Chagas disease and in the immigrant populations in nonendemic regions. Additionally, our study showed that PWH with advancing immunosuppression have higher levels of estimated parasitemia measured by qPCR and suggests a role for active surveillance for Chagas reactivation with consideration of treatment with antitrypanosomal therapy until immune reconstitution can be achieved en_US
dc.language.iso eng
dc.publisher American Journal of Tropical Medicine and Hygiene
dc.relation.ispartofseries American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject HIV en_US
dc.subject Chagas Disease en_US
dc.subject Quantitative Polymerase Chain en_US
dc.subject Trypanosoma cruzi Parasitemia en_US
dc.subject Patients en_US
dc.subject Cochabamba en_US
dc.subject Bolivia en_US
dc.title HIV and Chagas Disease: An Evaluation of the Use of Real-Time Quantitative Polymerase Chain Reaction to Measure Levels of Trypanosoma cruzi Parasitemia in HIV Patients in Cochabamba, Bolivia en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.4269/ajtmh.20-1141
dc.relation.issn 1476-1645


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