Screening for Trypanosoma cruzi in patients living with the human immunodeficiency virus (PWH) in the Peruvian Amazon

IF 5.6 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease Pub Date : 2025-11-01 Epub Date: 2025-10-28 DOI:10.1016/j.tmaid.2025.102927

Silvia Otero-Rodriguez , Martin Casapia-Morales , Lilia-Lorena Pinedo-Ramirez , Esperanza Merino , Eva H. Clark , José-Manuel Ramos-Rincón

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引用次数: 0

Abstract

Introduction

Chagas disease (CD) - Trypanosoma cruzi infection - in people living with HIV (PWH), particularly those with advanced CD4 T cell depletion, can lead to severe syndromes affecting the central nervous system and the heart.

Methods

We performed a cross-sectional study to screen for CD among PWH in Iquitos, Peru, between October 2023 and May 2024, with the objective of understanding the frequency of infection in this population. Adults with confirmed HIV attending outpatient services at two regional hospitals were enrolled. Two ELISA tests (lysate and recombinant) were used, and discordant results were adjudicated by indirect chemiluminescence immunoassay (CLIA).

Result

Of 534 PWH, the median age was 41 years (IQR 32–49), 66.1 % were male, the median current CD4⁺ count was 443/μL, and 75.8 % had an undetectable viral load. Two discordant serologic results were resolved with a negative CLIA, resulting in no confirmed CD cases.

Conclusion

The prevalence of T. cruzi infection is likely very low in urban and peri-urban areas of Iquitos. Continued epidemiological surveillance is essential to monitor potential changes over time.

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秘鲁亚马逊地区人类免疫缺陷病毒（PWH）患者克氏锥虫筛查

前言：恰加斯病（恰加斯病）——克氏锥虫感染——在艾滋病毒感染者（PWH）中，特别是那些CD4 T细胞耗损晚期的人，可导致影响中枢神经系统和心脏的严重综合征。方法：我们在2023年10月至2024年5月期间对秘鲁伊基托斯的PWH进行了一项横断面研究，以筛查CD，目的是了解该人群的感染频率。在两家地区医院接受门诊服务的成年艾滋病毒确诊患者被纳入研究。采用两种酶联免疫吸附试验（裂解物和重组物），用间接化学发光免疫分析法（CLIA）判定不一致的结果。结果：534例PWH患者中位年龄41岁（IQR 32 ~ 49岁），66.1%为男性，当前CD4+中位计数为443/μL， 75.8%的患者病毒载量检测不出。两个不一致的血清学结果被CLIA阴性解决，导致没有确诊的CD病例。结论：伊基托斯市城市及城郊地区克氏t形虫感染率可能很低。持续的流行病学监测对于监测长期的潜在变化至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Travel Medicine and Infectious Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-INFECTIOUS DISEASES

CiteScore

19.40

自引率

1.70%

发文量

211

审稿时长

49 days

期刊介绍： Travel Medicine and Infectious Disease Publication Scope: Publishes original papers, reviews, and consensus papers Primary theme: infectious disease in the context of travel medicine Focus Areas: Epidemiology and surveillance of travel-related illness Prevention and treatment of travel-associated infections Malaria prevention and treatment Travellers' diarrhoea Infections associated with mass gatherings Migration-related infections Vaccines and vaccine-preventable disease Global policy/regulations for disease prevention and control Practical clinical issues for travel and tropical medicine practitioners Coverage: Addresses areas of controversy and debate in travel medicine Aims to inform guidelines and policy pertinent to travel medicine and the prevention of infectious disease Publication Features: Offers a fast peer-review process Provides early online publication of accepted manuscripts Aims to publish cutting-edge papers