Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil

The specific roles of parasite characteristics and immunological factors of the host in Chagas disease progression and prognosis are still under debate. Trypanosoma cruzi genotype may be an important determinant of the clinical chronic Chagas disease form and prognosis. This study aimed to identify...

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Bibliographic Details
Published in:PloS one 2020-12, Vol.15 (12), p.e0243008-e0243008
Main Authors: Nielebock, Marco Antonio Prates, Moreira, Otacílio C, Xavier, Samanta Cristina das Chagas, Miranda, Luciana de Freitas Campos, Lima, Ana Carolina Bastos de, Pereira, Thayanne Oliveira de Jesus Sales, Hasslocher-Moreno, Alejandro Marcel, Britto, Constança, Sangenis, Luiz Henrique Conde, Saraiva, Roberto Magalhães
Format: Article
Language:English
Subjects:
Adult
Aged
Biology and Life Sciences
Blood
Blood culture
Brazil - epidemiology
Care and treatment
Chagas disease
Chagas Disease - diagnosis
Chagas Disease - epidemiology
Chronic Disease - epidemiology
Cohort Studies
Congestive heart failure
Coronary artery disease
Deoxyribonucleic acid
Development and progression
DNA
Female
Follow-Up Studies
Genetic aspects
Genotypes
Health aspects
Heart transplantation
Host-parasite relationships
Humans
Immunology
Infectious diseases
Laboratories
Male
Medical records
Medical research
Medicine and Health Sciences
Middle Aged
Molecular biology
Molecular Typing
Mortality
Parasites
Parasitic diseases
People and places
Prognosis
Protozoa
Research and Analysis Methods
Retrospective Studies
Transplantation
Tropical diseases
Trypanosoma cruzi
Trypanosoma cruzi - classification
Trypanosoma cruzi - genetics
Trypanosoma cruzi - physiology
Urban Population - statistics & numerical data
Vector-borne diseases
Young Adult
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Summary:The specific roles of parasite characteristics and immunological factors of the host in Chagas disease progression and prognosis are still under debate. Trypanosoma cruzi genotype may be an important determinant of the clinical chronic Chagas disease form and prognosis. This study aimed to identify the potential association between T. cruzi genotypes and the clinical presentations of chronic Chagas disease. This is a retrospective study using T. cruzi isolated from blood culture samples of 43 patients with chronic Chagas disease. From 43 patients, 42 were born in Brazil, mainly in Southeast and Northeast Brazilian regions, and one patient was born in Bolivia. Their mean age at the time of blood collection was 52.4±13.2 years. The clinical presentation was as follows 51.1% cardiac form, 25.6% indeterminate form, and 23.3% cardiodigestive form. Discrete typing unit (DTU) was determined by multilocus conventional PCR. TcII (n = 40) and TcVI (n = 2) were the DTUs identified. DTU was unidentifiable in one patient. The average follow-up time after blood culture was 5.7±4.4 years. A total of 14 patients (32.5%) died and one patient underwent heart transplantation. The cause of death was sudden cardiac arrest in six patients, heart failure in five patients, not related to Chagas disease in one patient, and ignored in two patients. A total of 8 patients (18.6%) progressed, all of them within the cardiac or cardiodigestive forms. TcII was the main T. cruzi DTU identified in chronic Chagas disease Brazilian patients (92.9%) with either cardiac, indeterminate or cardiodigestive forms, born at Southeast and Northeast regions. Other DTU found in much less frequency was TcVI (4.8%). TcII was also associated to patients that evolved with heart failure or sudden cardiac arrest, the two most common and ominous consequences of the cardiac form of Chagas disease.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0243008