Treatment of Chagas’ disease with itraconazole: electrocardiographic and parasitological conditions after 20 years of follow-up
Author
dc.contributor.author
Apt Baruch, Werner
Author
dc.contributor.author
Arribada, Arturo
es_CL
Author
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Zulantay Alfaro, Inés
es_CL
Author
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Rodríguez Borges, Jorge
es_CL
Author
dc.contributor.author
Saavedra, Miguel
es_CL
Author
dc.contributor.author
Muñoz, Andrea
Admission date
dc.date.accessioned
2014-01-31T12:03:28Z
Available date
dc.date.available
2014-01-31T12:03:28Z
Publication date
dc.date.issued
2013
Cita de ítem
dc.identifier.citation
J Antimicrob Chemother 2013; 68: 2164–2169
en_US
Identifier
dc.identifier.other
doi:10.1093/jac/dkt135
Identifier
dc.identifier.uri
https://repositorio.uchile.cl/handle/2250/129234
General note
dc.description
Artículo de publicación ISI
en_US
Abstract
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Objectives: To evaluate cases of chronic Chagas’ disease for the long-term effects of treatment with itraconazole
on Trypanosoma cruzi infections and the regression or development of ECG abnormalities.
Methods: In March 1992, we treated 46 patients with chronic Chagas’ disease with 6 mg/kg/day of itraconazole
for 120 days in a blind evaluation. The patients came from an area of Chile where the disease was endemic and
were checked for ECG abnormalities and with xenodiagnosis (XD) or real-time XD-quantitative PCR (XD-qPCR) for
Trypanosoma cruzi infection before treatment and once a year for 20 years.
Results: Twenty-one patients proved to be uninfected after 20 years and 15 of the patients had a normal ECG.
Of the latter cases, 32.6% could be considered cured, although all of them had positive serology. Itraconazole
prevents the development of ECG abnormalities, because after 20 years of treatment only 10.86% of patients
developed ECG abnormalities (Z¼1.70, P¼0.046). XD-qPCR performed on 16 patients demonstrated 10 cases
with ,1.42 parasites/mL: eight with ,1 parasite/mL, one with 1.42 parasites/mL and one with 1.01 parasites/mL.
Five patients had more than 11.75 parasites/mL, all of them with a positive XD; these cases correspond to therapy
failure, since re-infection was ruled out. In one case, XD-qPCR did not present amplification.
Conclusions: Itraconazole is useful in the treatment of chronic Chagas’ disease as it prevented the development of
ECG abnormalities and cured 32.6% of patients.