Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease
de Lima, Ana Carolina Bastos; Mendes, Veronica Gonçalves; Ferreira, Roberto Rodrigues; Nisimura, Lindice Mitie; Horita, Samuel Iwao Maia; Veloso, Henrique H; Costa, Andréa R; da Silva, Gilberto Marcelo S; Sangenis, Luiz Henrique C; Holanda, Marcelo T; Rimolo, Lorena; Cunha, Ademir B; Garzoni, Luciana Ribeiro; Hasslocher-Moreno, Alejandro Marcel; Mediano, Mauro Felippe F; Moreira, Otacílio da Cruz; Britto, Constança; Saraiva, Roberto M.
Mem. Inst. Oswaldo Cruz
; 118: e230115, 2023. tab, graf
Artículo
en Inglés
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LILACS-Express
| ID: biblio-1529020
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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