Parasitological cure and clinical benefits of benznidazole treatment in patients from the Jequitinhonha Valley, MG, Brazil, with recent chronic infection by Trypanosoma cruzi II.

Background: The treatment of the early chronic phase of Chagas disease (CD) may result in high rates of parasitological cure, which may be associated with clinical benefits.

Objectives: To evaluate children with CD from the Jequitinhonha Valley, MG, Brazil, treated with benznidazole (BZ), employing classic and alternative methodologies.

Methods: Before and after treatment, nine individuals were examined by haemoculture, polymerase chain reaction (PCR), conventional enzyme-linked immunosorbent assay (ELISA), electrocardiogram, echocardiogram, and thoracic and gastrointestinal X-ray. Eight individuals were in the indeterminate clinical form of CD, and one was in the mild cardiac form. After treatment, all individuals were re-evaluated periodically for 4-26 years using the same methodologies cited and anti-live trypomastigotes antibodies by flow-cytometry-FC-ALTA and quantitative PCR (qPCR).

Findings: The cure rate by the classic cure criteria was 33.33%. By the alternative cure criteria using FC-ALTA and qPCR, the rates of cure were 50% and 78%, respectively. Post-treatment clinical evaluations revealed stability in 5/9 and discrete clinical evolution in 4/9 individuals.

Main conclusions: It was demonstrated the effectiveness of BZ treatment in recent chronic infections of CD with low or higher rates of parasitological cure according to the cure criterion used after long-term follow-up. The clinical status of the individuals remained stable or evolved slowly, suggesting clinical benefits from BZ treatment.