Serological screening of Chagas' disease in HIVpositive immigrants proceeding from endemic areas in Spain
Abstract number: P1279
Rodríguez-Guardado A., Asensi V., Rodríguez Pérez M., Mejuto P., Alonso P., Cartón J.A.
Background: Chagas' disease is an opportunistic infection in the setting of HIV/AIDS. The arrival of HIV positive immigrant proceeding from endemic areas to non-endemic countries makes possible the detection of Chagas' disease in this group of patients. We describe the results of a screening program conducted in HIV + immigrant population coming from endemic areas.
Methods: We determined anti-T. cruzi antibodies in all HIV patients proceeding from endemic areas in follow-up at the Infectious Disease Unit of Hosp. Central of Asturias, during 2007. The ID-Chagas antibody test (Particle Gel Immuno Assay PaGIA, DiaMed-ID-) was used as screening assay. The positive cases were confirmed with a second ELISA (Total Ag) and a nested PCR. In all the confirmed cases a protocol that included a clinical-epidemiological evaluation, chest X ray, EKG, oesophagogastroscopy, barium enema, and echocardiography was applied.
Results: We screened 19 HIV positive immigrants (mean age 36 years). The procedence countries were: Brazil and Ecuador (26% each), Colombia (21%), Paraguay, Uruguay, Argentina, Dominican Republic and Bolivia (5.2% cases each). Two patients (10.5%) had positive antibody test for Chagas' disease, that was confirmed in both cases. PCR was positive in both cases. Direct microscopic examination of blood was negative in both. The positive patients were a man coming from Bolivia and a woman from Paraguay. Both lived in houses where the reproduction of triatomine bugs is possible. Both were on HAART with CD4 of 348 and 456 CD4+ cells/mm3 and with HIV-1 RNA <10 copies/ml. Both patients were asymptomatic and had normal additional studies for Chagas' disease.
Conclusions: The overlap of HIV and T. cruzi infection occurs not only in endemic areas but also in non-endemic areas of North America and Europe where the diagnosis may be even more difficult. It is necessary the realisation of screening programs in this group of population for the early diagnostic of Chagas' disease.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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