Treatment of Chronic Chagasic Patients: Is Killing the Parasite the Only Option?

Abstract

Chagas disease is a tropical illness characterised by arrhythmias, heart failure, and eventually death. In approximately 10–30% of patients, chronic disease appears 10–30 years after infection onset. One of the biggest challenges for treatment is how to manage disease progression during the non-symptomatic phase to avoid the most life-threatening consequences of Chagas disease. The aim of this review is to evaluate the empirical rationale for an alternative therapy based on pathophysiological mechanisms that lead to chronic cardiac pathology and that have the possibility of evaluation through serological markers. The author identifies L-arginine serum levels, IL-2, and short-form Cha autoantibodies as possible markers for Chagas disease and discusses the reports regarding the therapeutic potential of amiodarone and angiotensin-converting enzyme inhibitors to modulate the electrophysiological, inflammatory, and vascular disturbances that lead to symptomatic Chagas disease. This review considers this discussion to improve the comprehension of therapeutic alternatives based on the vast literature detailing Chagas disease’s pathophysiology.