AEGiS-11IAC: Chagas disease in HIV-infected hemophiliacs: clinical and laboratory follow-up.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Chagas disease in HIV-infected hemophiliacs: clinical and laboratory follow-up.

Int Conf AIDS 1996 Jul 7-12; 11:447 (abstract no. Pub.B.1058)
Da-Cruz AM, Igreja RP, Dantas W, Pirmez C, Junqueira AC, Pacheco RS, Gonzaga AL; Hospital da Casa do Hemofilico-CHESC, Rio de Janeiro, Brazil. Fax: 00.55.21.280-1589. E-mail: alda@dcc001.cict.fiocruz.br.

OBJECTIVE: In the last few past years new immunopathologic aspects have been described in AIDS patients with Chagas disease-associated, most of them displaying fatal central nervous system lesions related to parasite's reactivation. It is described a clinical and laboratorial follow-up (from 07/94 up to 01/96) of three HIV-infected patients screened for Trypanosoma cruzi infection by serological tests (ELISA or indirect immunofluorescence) among 125 hemophiliacs.Case Reports: Patient 1 - AA, 44 years old, hemophilia B, AIDS CDC-C3 (since 1991), indeterminate form of Chagas disease; Patient 2 - AS, 29 years old, hemophilia A, AIDS CDC-A2, cardiac form of Chagas disease; Patient 3 - MCS, 49 years old, hemophilia A, AIDS CDC-A1, cardiac form of Chagas disease.

RESULTS: Diagnosis of Chagas disease was proved in all three patients by isolation of the parasites by xenodiagnosis and/or blood culture. The parasites were characterized as T. cruzi by molecular hybridization techniques using radioalabed specific probes. Parasites were not seen either by direct examination of peripheral blood or cerebrospinal fluid (CSF) exam. Despite the presence of circulant parasites there was no clinical evidence of acute manifestation of Chagas disease, no significant alteration on the CSF cytology or biochemistry and no abnormal finding on the tomograms of the brain.

CONCLUSION: As far as we known there is not an established approach concerning how to manipulate the T. cruzi infection in AIDS patients. These three patients are still under investigation but many points need to be elucidated such as: the risk of reactivation ; which parameters can be used to monitor the infection and/or disease reactivation; which drug can be used as chemoprophylaxis to avoid reactivation, and finally when and how treat these cases?Supported by Sociedade Luiz Fernando Bare, CNPq and International Atomic Energy Agence.

Keywords: AEGIS, Chagas Disease, Acquired Immunodeficiency Syndrome, Xenodiagnosis, Hemophilia A, Infection, AIDS-Related Opportunistic Infections, Toxoplasmosis, Cerebral, HIV Infections, Heart, Fluorescent Antibody Technique, Indirect, Human, cytology, ICA11

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