Mem Inst Oswaldo Cruz, Rio de Janeiro, VOLUME 118 | 2023
Research Articles

Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease

Ana Carolina Bastos de Lima1, Veronica Gonçalves Mendes2, Roberto Rodrigues Ferreira3, Lindice Mitie Nisimura3, Samuel Iwao Maia Horita3, Henrique H Veloso2, Andréa R Costa2, Gilberto Marcelo S da Silva2, Luiz Henrique C Sangenis2, Marcelo T Holanda2, Lorena Rimolo4, Ademir B Cunha4, Luciana Ribeiro Garzoni3, Alejandro Marcel Hasslocher-Moreno2, Mauro Felippe F Mediano2, Otacílio da Cruz Moreira5, Constança Britto1, Roberto M Saraiva2,+

1Molecular Biology and Endemic Diseases Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brasil
2Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brasil
3Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brasil
4Antonio Pedro University Hospital, Fluminense Federal University, Niteró, RJ, Brasil
5Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Av. Brasil 4365, Rio de Janeiro, RJ, Brasil

DOI: 10.1590/0074-02760230115
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ABSTRACT

BACKGROUND A positive Trypanosoma cruzi polymerase chain reaction (PCR) is associated with a worse prognosis in patients with chronic Chagas disease (CD).
OBJECTIVES To study the association of clinical, electrocardiographic, and echocardiographic characteristics and biomarker blood levels with positive T. cruzi PCR in chronic CD.
METHODS This is a single-centre observational cross-sectional study. Positive T. cruzi PCR association with clinical, electrocardiographic, and echocardiographic characteristics, and biomarker blood levels were studied by logistic regression analysis. p values < 0.05 were considered significant.
FINDINGS Among 333 patients with chronic CD (56.4% men; 62 ± 10 years), T. cruzi PCR was positive in 41.1%. Stepwise multivariate logistic regression showed an independent association between positive T. cruzi PCR and diabetes mellitus {odds ratio (OR) 0.53 [95% confidence interval (CI) 0.30-0.93]; p = 0.03}, right bundle branch block [OR 1.78 (95% CI 1.09-2.89); p = 0.02], and history of trypanocidal treatment [OR 0.13 (95% CI 0.04-0.38); p = 0.0002]. Among patients with a history of trypanocidal treatment (n = 39), only four (10%) patients had a positive T. cruzi PCR.
MAIN CONCLUSIONS Among several studied parameters, only diabetes mellitus, right bundle branch block, and history of trypanocidal treatment showed an independent association with positive T. cruzi PCR. History of trypanocidal treatment was a strong protective factor against a positive T. cruzi PCR.

key words: Chagas disease Trypanosoma cruzi clinical forms biomarkers
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Financial support: FAPERJ (grant numbers E-26/201.561/2014 and E-26/110.176/2014 to Dr Saraiva), and CNPq (grant number 305088/2013-0 to Dr Saraiva).
OCM and CB are researcher fellows of CNPq (311 539/2020-3 and 304 308/2019-3, respectively), and FAPERJ (E-26/201.096/2022 and E-26/201.213/2022, respectively).
ACBL and VGM contributed equally to this work.
+ Corresponding author: roberto.saraiva@ini.fiocruz.br
ORCID https://orcid.org/0000-0002-2263-4261
Received 30 June 2023
Accepted 10 November 2023

HOW TO CITE
de Lima ACB, Mendes VG, Ferreira RR, Nisimura LM, Horita SIM, Veloso HH, et al. Predictors of Trypanosoma cruzi PCR positivity in patients with chronic Chagas disease. Mem Inst Oswaldo Cruz. 2023; 118: e230115.

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