Criteria of Chagas disease cure.
نویسنده
چکیده
The investigation of the rational etiological treatment of Chagas disease, through controlled clinical trials, only began around half a century after the discovery of the disease. This resulted from a meeting held in Rio de Janeiro, in 1962, between a number of Brazilian researchers and representatives from the pharmaceutical industry (Anais 1962). Two facts were then known: (1) nitrofuran compounds are active against Trypanosoma cruzi: (2) long course administration of nitrofurazone prevents the development of experimental infection in mouse. At that meeting, we had the opportunity of discussing methods of evaluation of therapeutic efficacy. We discarded clinical criteria, due to the slow natural evolution of the disease. Furthermore, since the main objective of specific therapy is the eradication of the causative organism, the criterion of cure should be the proof of the elimination of T. cruzi, demonstrated in practice by the post-therapeutic consistent negative parasitological and serological tests, at that time, respectively, xenodiagnosis (XD) and complement fixation (CF). In the years following the landmark 1962 meeting, we examined, at the University Hospital and private practice, in Belo Horizonte, MG, Brasil, 2,405 Chagas disease patients, 47 with the acute and 2,358 with various chronic forms (Table I). We performed several controlled clinical trials, with nitrofurazone, l-furaltadone, nifurtimox, benznidazole, ketoconazole, among other drugs. In addition, new diagnostic tests were introduced: hemoculture (HC), quantitative indirect immunofluorescence test (IF), quantitative indirect hemagglutination test (HA) and complement mediated lysis (CoML). IMMUNE RESPONSE
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ورودعنوان ژورنال:
- Memorias do Instituto Oswaldo Cruz
دوره 94 Suppl 1 شماره
صفحات -
تاریخ انتشار 1999