title: Molecular diagnosis and typing of Trypanosoma cruzi populations and lineages in cerebral Chagas disease in a patient with AIDS.
abstract: 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.
authors.affiliation: Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular (INGEBI-CONICET), Buenos Aires, Argentina.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Burgos
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Begher
authors.forename: Jorge M
authors.initials: JM
authors.lastname: Freitas
authors.forename: Margarita
authors.initials: M
authors.lastname: Bisio
authors.forename: Tomas
authors.initials: T
authors.lastname: Duffy
authors.forename: Jaime
authors.initials: J
authors.lastname: Altcheh
authors.forename: Ricardo
authors.initials: R
authors.lastname: Teijeiro
authors.forename: Horacio
authors.initials: H
authors.lastname: Lopez Alcoba
authors.forename: Florencia
authors.initials: F
authors.lastname: Deccarlini
authors.forename: Hector
authors.initials: H
authors.lastname: Freilij
authors.forename: Mariano J
authors.initials: MJ
authors.lastname: Levin
authors.forename: Jorge
authors.initials: J
authors.lastname: Levalle
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Macedo
authors.forename: Alejandro G
authors.initials: AG
authors.lastname: Schijman
mesh_terms: 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*
chemical_list: D018105:DNA, Kinetoplast; D016054:DNA, Protozoan