Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease.

IF 2.5 4区医学 Q2 PARASITOLOGY Memorias do Instituto Oswaldo Cruz Pub Date : 2023-12-15 eCollection Date: 2023-01-01 DOI:10.1590/0074-02760230115

Ana Carolina Bastos de Lima, Veronica Gonçalves Mendes, Roberto Rodrigues Ferreira, Lindice Mitie Nisimura, Samuel Iwao Maia Horita, Henrique H Veloso, Andréa R Costa, Gilberto Marcelo S da Silva, Luiz Henrique C Sangenis, Marcelo T Holanda, Lorena Rimolo, Ademir B Cunha, Luciana Ribeiro Garzoni, Alejandro Marcel Hasslocher-Moreno, Mauro Felippe F Mediano, Otacílio da Cruz Moreira, Constança Britto, Roberto M Saraiva

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Abstract

Background: A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD).

Objectives: To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD.

Methods: This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant.

Findings: Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR.

Main conclusions: Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

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慢性恰加斯病患者体内克氏锥虫 PCR 阳性的预测因素。

背景：克氏锥虫聚合酶链反应（PCR）阳性与慢性南美锥虫病（CD）患者的预后有关：克鲁斯锥虫聚合酶链反应（PCR）阳性与慢性恰加斯病（CD）患者预后较差有关：研究慢性南美锥虫病患者的临床、心电图和超声心动图特征以及血液中生物标志物水平与南美锥虫聚合酶链反应阳性的相关性：这是一项单中心观察性横断面研究。通过逻辑回归分析研究了T. cruzi PCR阳性与临床、心电图、超声心动图特征以及血液中生物标志物水平的关系：在 333 名慢性 CD 患者（56.4% 为男性；62 ± 10 岁）中，41.1% 的患者 T. cruzi PCR 呈阳性。逐步多变量逻辑回归显示，T. cruzi PCR 阳性与糖尿病{多态比 (OR) 0.53 [95% 置信区间 (CI) 0.30-0.93]; p = 0.03}、右束支传导阻滞[OR 1.78 (95% CI 1.09-2.89); p = 0.02]和杀锥虫治疗史[OR 0.13 (95% CI 0.04-0.38); p = 0.0002]之间存在独立关联。在有锥虫治疗史的患者（39 人）中，只有 4 人（10%）的 T. cruzi PCR 呈阳性：主要结论：在几项研究参数中，只有糖尿病、右束支传导阻滞和杀锥虫治疗史与 T. cruzi PCR 阳性有独立关联。杀锥虫治疗史是防止 T. cruzi PCR 阳性的一个强有力的保护因素。

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来源期刊

Memorias do Instituto Oswaldo Cruz 医学-寄生虫学

CiteScore

5.00

自引率

3.60%

发文量

审稿时长

3-8 weeks

期刊介绍： Memórias do Instituto Oswaldo Cruz is a journal specialized in microbes & their vectors causing human infections. This means that we accept manuscripts covering multidisciplinary approaches and findings in the basic aspects of infectious diseases, e.g. basic in research in prokariotes, eukaryotes, and/or virus. Articles must clearly show what is the main question to be answered, the hypothesis raised, and the contribution given by the study. Priority is given to manuscripts reporting novel mechanisms and general findings concerning the biology of human infectious prokariotes, eukariotes or virus. Papers reporting innovative methods for diagnostics or that advance the basic research with these infectious agents are also welcome. It is important to mention what we do not publish: veterinary infectious agents research, taxonomic analysis and re-description of species, epidemiological studies or surveys or case reports and data re-analysis. Manuscripts that fall in these cases or that are considered of low priority by the journal editorial board, will be returned to the author(s) for submission to another journal.