Screening for Trypanosoma cruzi infection (Chagas disease) in the Latin American population living with HIV in London

Abstract Background There are an estimated 2482 people born in Latin American countries receiving care for HIV in the United Kingdom. Although national guidance recommends screening for Trypanosoma cruzi infection (Chagas disease) in this population, there is no formal screening programme. The aim of this study was to investigate the sero‐epidemiology of T. cruzi in Latin American people living with HIV in London, with a view to informing screening strategies. Methods This was a cross‐sectional study, using serological screening for T. cruzi and questionnaires. Adults receiving HIV care in three London hospital outpatient clinics and who were born in one of the 21 Chagas‐endemic countries of South America, Central America or Mexico were identified by searching electronic medical records for country of birth codes. Eligible participants were invited to undergo T. cruzi screening (a single recombinant immunoglobulin G (IgG)‐enzyme‐linked immunosorbent assay (ELISA)) during routine HIV outpatient appointments. Positive screening tests were confirmed with an immunofluorescence antibody test, with discordant results resolved by an adjudicating immunoblot. Results A total of 351 participants were recruited between June 2023 and March 2025, including 181 (52%) who were born in Brazil, 73 (21%) in Colombia, 19 (5%) in Ecuador, 16 (5%) in Argentina, 15 (4%) in Venezuela and 12 (3%) in Bolivia. Uptake of serological screening was high (97% when offered face to face). Four participants (1%) had a positive screening test, of whom one had confirmed T. cruzi infection (seroprevalence 0.3%, 95% CI 0.01–1.6%), and three were deemed false positive screening tests. Conclusions We report a low seroprevalence of T. cruzi infection in Latin American migrants in London living with HIV. Since the clinical consequences of untreated T. cruzi infection can be fatal, screening uptake is high, and individuals in non‐endemic countries generally only need to be screened once, we recommend testing all Latin American people with HIV, especially women of reproductive age, those from high‐prevalence countries and those with poor immune‐virological control.