Key result
Prior trypanocidal treatment is linked to ~87% lower odds of positive T. cruzi PCR in Chagas.
Why the study?
A positive Trypanosoma cruzi PCR is linked to worse prognosis in chronic Chagas disease, but its association with clinical, electrocardiographic, echocardiographic, and biomarker features required investigation.
Cross-Sectional (n=333)
No
Odds Ratio: 0.13 (95% CI 0.04–0.38)
p-value: p=0.0002
In patients with chronic Chagas disease, a history of trypanocidal treatment is a strong protective factor against T. cruzi PCR positivity, whereas right bundle branch block is associated with higher positivity.
May support trypanocidal treatment benefit in chronic Chagas; hypothesis-generating and requires prospective validation.
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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Lima et al. (2023) conducted a cross-sectional in chronic Chagas disease (n=333). History of trypanocidal treatment vs. No history of trypanocidal treatment was evaluated on Positive Trypanosoma cruzi polymerase chain reaction (PCR) (OR 0.13, 95% CI 0.04-0.38, p=0.0002). History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR in patients with chronic Chagas disease (OR 0.13; 95% CI 0.04-0.38; p=0.0002).
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