Evaluación serológica del tratamiento de la enfermedad de Chagas crónica con alopurinol e itraconazol / Serologic evaluation of treatment of chronic Chagas disease with allopurinol and itraconazole

ABSTRACT

Background: Chagas disease is endemic in Chile. Allopurinol and itraconazole have activity against Trypanosoma cruzi and are recommended for the treatment of chronic disease in adults. Aim: To evaluate the chemotherapeutic effects of allopurinol and itraconazole using conventional and non conventional serologic test. Patients and methods: Sera of 90 patients with chonic Chagas disease were studied before and after 9 to 11 months of treatment with allopurinol or itraconazole and after two month of treatment with placebo. Indirect immunofluorescence, ELISA and Western Blot analysis were the conventional serologic tests used and antibody dependent complement mediated lysis (CoML) the non conventional test. Results: There were no differences in ELISA and indirect immunofluorescence tests before and after therapy. Antigenic recognition profiles by Western Blot showed qualitative and quantitative differences in a small number of cases. CoML showed that the greater negativity was achieved in the Chagasic group treated with allopurinol or itraconazole that had a negative xenodiagnosis before drugs treatment (35.8 and 61.6 percent, respectively). Conclusions: There is a reversion of lytic activity in sera of patients with negative xenodiagnosis before treatment, suggesting the parasitemia could be an important parameter to be considered in the chemotherapy of Chagas disease