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Title: Towards a Paradigm Shift in the Treatment of Chronic Chagas Disease
Authors: Viotti, R.
Noya, B. Alarcón
Jorge, T. Araujo
Grijalva, M. J.
Guhl, F.
López, M. C.
Ramsey, J. M.
Ribeiro, I.
Schijan, A. G.
Sosa-Estani, S.
Torrico, F.
Gascon, J.
Affilliation: Hospital Interzonal General de Agudos (HIGA) Eva Perón. Sección Chagas. Servicio de Cardiología. Buenos Aires, Argentina.
Universidad Central de Venezuela (IMT-UCV). Instituto de Medicina Tropical. Caracas, Venezuela.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa Integrado de Doença de Chagas. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ, Brasil.
Universidad Católica del Ecuador (CIEI-PUCE). Centro de Investigación de Enfermedades Infecciosas. Quito, Ecuador / Ohio University. Tropical Disease Institut. Athens, Ohio, USA.
Universidad de los Andes (UA-CIMPAT). Centro de Investigaciones en Microbiología y Parasitología Tropical. Bogotá, Colombia.
Consejo Superior de Investigaciones Científicas (IPBLN-CSIC). Instituto de Parasitología y Biomedicina Lopez-Neyra. Granada, Spain.
Instituto Nacional de Salud Pública (CRISP-INSP).Centro Regional de Investigación en Salud Pública. Tapachula, Chiapas, Mexico.
Drugs for Neglected Diseases Initiative (DNDi). Geneva, Switzerland.
Instituto de Investigaciones en Ingeniería Genética y Biología Molecular (INGEBI).CONICET. Buenos Aires, Argentina.
Instituto Nacional de Parasitología Dr. Mario Fatala Chaben (INP)-ANLIS Dr. Carlos G. Malbran, Buenos Aires, Argentina.
Universidad Mayor de San Simón (UMSS). Cochabamba, Bolivia.
Barcelona Center for International Health Research (CRESIB). Hospital Clinic/IDIBAPS. Barcelona, Spain.
Abstract: Treatment for Chagas disease with currently available medications is recommended universally only for acute cases (all ages) and for children up to 14 years old. The World Health Organization, however, also recommends specific antiparasite treatment for all chronic-phase Trypanosoma cruzi-infected individuals, even though in current medical practice this remains controversial, and most physicians only prescribe palliative treatment for adult Chagas patients with dilated cardiomyopathy. The present opinion, prepared by members of the NHEPACHA network (Nuevas Herramientas para el Diagnóstico y la Evaluación del Paciente con Enfermedad de Chagas/New Tools for the Diagnosis and Evaluation of Chagas Disease Patients), reviews the paradigm shift based on clinical and immunological evidence and argues in favor of antiparasitic treatment for all chronic patients. We review the tools needed to monitor therapeutic efficacy and the potential criteria for evaluation of treatment efficacy beyond parasitological cure. Etiological treatment should now be mandatory for all adult chronic Chagas disease patients.
Keywords: Chagas Disease
Trypanosoma cruzi
DeCS: Doença de Chagas
Trypanosoma cruzi
Issue Date: 2014
Publisher: American Society for Microbiology
Citation: VIOTTI, R. et al. Towards a Paradigm Shift in the Treatment of Chronic Chagas Disease. Antimicrobial Agents and Chemotherapy, v.58, n.2, p.635-639, Feb. 2014.
ISSN: 1098-6596
Copyright: open access
Appears in Collections:IOC - Artigos de Periódicos

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