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• W4243362633 abstract "Background: Trypanosoma cruzi (T. cruzi) reactivation in HIV patients is considered an opportunistic infection, usually with fatal outcome. The aim of this study was to describe epidemiological and clinical features of T. cruzi infection in HIV patients, and compare these findings between patients with and without Chagas’ disease reactivation. Methods & Materials: Medical records of T. cruzi-HIV co-infected patients assisted at the Muñiz Infectious Diseases Hospital from January 2005 to December 2014 were retrospectively reviewed. Epidemiological and clinical features were assessed and compared between patients with and without Chagas’ disease reactivation. Results: The medical records of 80 T. cruzi-HIV co-infected patients were reviewed, 63 of them were males. Their median age at Chagas’ disease diagnosis was 40.5 years (IQR 13 years), and their median age at HIV diagnosis was 34.5 years (IQR 20.5 years). The most likely route of T. cruzi infection was vector-borne, 32/80 patients, followed by intravenous drug use in 12/80. There were 9/80 patients with reactivation. Patients without reactivation had a significantly higher CD4 T cell count at T. cruzi infection diagnosis (144 cells/μl vs. 30cells/μl, p = 0.026), a higher minimal CD4 T cell count (94 cells/μl vs. 30cells/μl, Mann-Whitney U test p = 0.032), and less opportunistic diseases prior to or at the moment of Chagas’ disease diagnosis, although without significant differences. Chagas’ disease reactivation involved CNS alone in 7 patients, while CNS and heart were affected simultaneously in 2 patients. Trypomastigotes were observed in CSF samples of all patients (n = 9), while parasitemia was studied in 7 patients being positive in only one of them. Chagas’ disease serology was negative in 2/9 patients with reactivation. T. cruzi reactivation was considered the cause of death in 6 of the 9 patients with reactivation. Conclusion: Chagas’ disease reactivation is an AIDS defined illness with high mortality rate. Serological assays for T.cruzi infection could be negative in severely immunodeficient patients. Direct parasitological techniques should be performed in patients with suspicion of T. cruzi reactivation. HIV patients with lower CD4 count are at higher risk of reactivation. HAART is mandatory for co-infected T. cruzi and HIV patients." @default.
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• W4243362633 date "2018-08-01" @default.
• W4243362633 modified "2023-10-09" @default.
• W4243362633 title "Clinical and epidemiological features of the chronic Trypanosoma cruzi infection in patients with HIV/AIDS in Buenos Aires, Argentina" @default.
• W4243362633 doi "https://doi.org/10.1016/j.ijid.2018.04.4131" @default.
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