Chagas disease screening among HIV-positive Latin American immigrants: an emerging problem

• Published in: European journal of clinical microbiology & infectious diseases Vol. 31; no. 8; pp. 1991 - 1997
• Main Authors: Llenas-García, J., Hernando, A., Fiorante, S., Maseda, D., Matarranz, M., Salto, E., Rubio, R., Pulido, F.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-08-2012; Springer; Springer Nature B.V
• Subjects: Adult; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Blood transfusions; Chagas disease; Chagas Disease - diagnosis; Chagas Disease - epidemiology; Cross-Sectional Studies; Disease prevention; Emigrants and Immigrants; Enzyme-Linked Immunosorbent Assay - methods; Epidemiology; Female; Fluorescent Antibody Technique - methods; Hispanic Americans; HIV; HIV Infections - complications; Human immunodeficiency virus; Human protozoal diseases; Human viral diseases; Humans; Immigrants; Immunochromatography - methods; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Industrialized nations; Infections; Infectious diseases; Internal Medicine; Male; Mass Screening - methods; Medical Microbiology; Medical sciences; Medical screening; Middle Aged; Parasitic diseases; Parasitology - methods; Patients; Protozoa; Protozoal diseases; Spain; Trypanosoma cruzi; Trypanosomiasis; Vector-borne diseases; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Spain; Bolivia; United States > US; Madrid Spain; Europe; Latin America; Argentina; Trypanosoma Cruzi; General Immigrant Population; Bolivian Origin; Benznidazole; Latin American Immigrant; Infection; Immunopathology; Protozoal disease; Immigrant; Microbiology; Viral disease; Chagas disease; AIDS; Parasitosis; Medical screening; Immune deficiency; Trypanosomiasis
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-011-1531-4

Chagas disease (CD) is an emergent disease in Europe that can behave as an opportunistic infection in HIV positive patients. The objective of this study was to evaluate the implementation of a CD screening programme in an HIV unit. An immunochromatography (ICT) of
Trypanosoma cruzi
was performed as a screening tool in HIV-positive patients born in CD endemic countries. ELISA and IFAT were used to confirm the diagnosis. A total of 155 patients, 116 males and 38 females, were included. Mean age was 36.9 years (±8.4) and mean length of stay in Spain at the screening was 7.1 years (±4.7).
T. cruzi
ICT was positive in four cases (2.6%), being confirmed (by ELISA and IFAT) in three of those (1.9%). Factors associated with confirmed positive
T.cruzi
serology were: Bolivia origin (
p
 = 0.016), Bolivia or Argentina origin (
p
 = 0.002), Southern Cone origin (
p
 = 0.015), rural origin (
p
 = 0.023), previously living in an adobe-made (p = 0.001) or thatch-roofed house (
p
 < 0.0001), having a previous CD test (
p
 = 0.015), previous knowledge about CD (
p
 = 0.019), about vector (
p
 = 0.009) or recorded seeing vectors at home (
p
 = 0.012). Units dealing with HIV patients from endemic areas of American trypanosomiasis should implement CD screening protocols. Interviews of patients coming from endemic areas should include CD epidemiological questions.