Molecular diagnosis and typing of Trypanosoma cruzi populations and lineages in cerebral Chagas disease in a patient with AIDS.
Trypanosoma cruzi DNA was amplified from an intracranial biopsy and peripheral blood of an HIV patient with encephalitis; this episode was indicative of AIDS and congenital Chagas disease. The analysis of a micro-satellite locus revealed a multiclonal parasite population at the brain lesion with a more complex minicircle signature than that profiled in blood using restriction fragment length polymorphism (RFLP)-PCR and low stringency single primer (LSSP) PCR. Interestingly, different sublineages of T. cruzi II were detected in blood and brain by means of spliced-leader and 24salpha ribosomal-DNA amplifications. Quantitative-competitive PCR monitored the decrease of parasitic load during treatment and secondary prophylaxis with benznidazole. The synergy between parasiticidal plus anti-retroviral treatments probably allowed the patient a longer survival than usually achieved in similar episodes. This is the first case report demonstrating a differential distribution of natural parasite populations and sublineages in Chagas disease reactivation, showing the proliferation of cerebral variants not detectable in peripheral blood.
Burgos
Juan M
JM
Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular (INGEBI-CONICET), Buenos Aires, Argentina.
Begher
Sandra B
SB
Freitas
Jorge M
JM
Bisio
Margarita
M
Duffy
Tomas
T
Altcheh
Jaime
J
Teijeiro
Ricardo
R
Lopez Alcoba
Horacio
H
Deccarlini
Florencia
F
Freilij
Hector
H
Levin
Mariano J
MJ
Levalle
Jorge
J
Macedo
Andrea M
AM
Schijman
Alejandro G
AG
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000818:Animals; D014355:Chagas Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D018105:DNA, Kinetoplast / Q000032:analysis; D016054:DNA, Protozoan / Q000032:analysis; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D014644:Genetic Variation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D014349:Trypanosoma cruzi / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
D018105:DNA, Kinetoplast; D016054:DNA, Protozoan