title: Trypanosoma cruzi in persons without serologic evidence of disease, Argentina.
abstract: Current diagnosis of chronic Chagas disease relies on serologic detection of specific immunoglobulin G against Trypanosoma cruzi. However, the presence of parasites detected by polymerase chain reaction (PCR) in patients without positive conventional serologic testing has been observed. We determined the prevalence and clinical characteristics of persons with seronegative results and T. cruzi DNA detected by PCR in a population at high risk for chronic American trypanosomiasis. We studied a total of 194 persons from two different populations: 110 patients were recruited from an urban cardiology clinic, and 84 persons were citizens from a highly disease-endemic area. Eighty (41%) of persons had negative serologic findings; 12 (15%) had a positive PCR. Three patients with negative serologic findings and positive PCR results had clinical signs and symptoms that suggested Chagas cardiomyopathy. This finding challenges the current recommendations for Chagas disease diagnosis, therapy, and blood transfusion policies.
authors.affiliation: Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina. nobaks@onenet.com.ar
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Salomone
authors.forename: Ana L
authors.initials: AL
authors.lastname: Basquiera
authors.forename: Adela
authors.initials: A
authors.lastname: Sembaj
authors.forename: Ana M
authors.initials: AM
authors.lastname: Aguerri
authors.forename: María E
authors.initials: ME
authors.lastname: Reyes
authors.forename: Mirtha
authors.initials: M
authors.lastname: Omelianuk
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Fernández
authors.forename: Julio
authors.initials: J
authors.lastname: Enders
authors.forename: Atilio
authors.initials: A
authors.lastname: Palma
authors.forename: José Moreno
authors.initials: JM
authors.lastname: Barral
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Madoery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001118:Argentina / Q000453:epidemiology; D014355:Chagas Disease / Q000453:epidemiology / Q000469:parasitology*; D003430:Cross-Sectional Studies; D016054:DNA, Protozoan / Q000737:chemistry / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012424:Rural Population; D016036:Seroepidemiologic Studies; D014349:Trypanosoma cruzi / Q000235:genetics / Q000302:isolation & purification*; D014505:Urban Population
chemical_list: D000913:Antibodies, Protozoan; D016054:DNA, Protozoan