title: Persistence of PCR-positive tissue in benznidazole-treated mice with negative blood parasitological and serological tests in dual infections with Trypanosoma cruzi stocks from different genotypes.
abstract: OBJECTIVE
  To assess different methodologies to better define an early post-therapeutic cure criterion after benznidazole treatment in BALB/c mice following mixed infection with dual Trypanosoma cruzi genotypes.
  
  
  METHODS
  According to the classical cure criteria, animals were classified as treated not cured (TNC = 76.4%), treated cured (TC = 12.5%) and dissociated (DIS = 11.1%) using parasitological [fresh blood examination (FBE), blood culture (BC) and blood PCR] and serological methods [conventional serology (CS-ELISA) and non-conventional serology (NCS-FC-ALTA)]. Tissues were also evaluated by PCR.
  
  
  RESULTS
  FBE was able to detect patent parasitaemia in only 18.1% of TNC and therapeutic failure was detected in 79.1% and 97.2% of TNC by BC and blood PCR, respectively. CS-ELISA should not be used before 3 months after treatment since it may lead to false-negative results. At 3 months after treatment with benznidazole, NCS-FC-ALTA was more efficient for categorizing the groups of treated mice. In the TNC group, although a decreased frequency of PCR-positive tissue was observed in several host tissues, increased positivity was also observed, despite the T. cruzi genotype combination. All TC animals presented at least two positive tissue-PCR results.
  
  
  CONCLUSIONS
  Our results confirm that NSC-FC-ALTA and blood PCR are the most suitable methods to early detect therapeutic failure in acute murine T. cruzi infection. Additionally, our data show that BC positivity is highly dependent upon the T. cruzi genotype combination. Moreover, our findings demonstrated that PCR tests performed on tissues from animals considered cured after benznidazole treatment still detected T. cruzi DNA, most probably indicating residual infection.
authors.affiliation: Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Ouro Preto, MG, Brazil. helen@nupeb.ufop.br
authors.forename: H R
authors.initials: HR
authors.lastname: Martins
authors.forename: L M
authors.initials: LM
authors.lastname: Figueiredo
authors.forename: J C O
authors.initials: JC
authors.lastname: Valamiel-Silva
authors.forename: C M
authors.initials: CM
authors.lastname: Carneiro
authors.forename: G L L
authors.initials: GL
authors.lastname: Machado-Coelho
authors.forename: D M
authors.initials: DM
authors.lastname: Vitelli-Avelar
authors.forename: M T
authors.initials: MT
authors.lastname: Bahia
authors.forename: O A
authors.initials: OA
authors.lastname: Martins-Filho
authors.forename: A M
authors.initials: AM
authors.lastname: Macedo
authors.forename: M
authors.initials: M
authors.lastname: Lana
mesh_terms: D000825:Animal Structures / Q000469:parasitology*; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001769:Blood / Q000469:parasitology*; D014355:Chagas Disease / Q000188:drug therapy* / Q000469:parasitology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D051379:Mice; D008807:Mice, Inbred BALB C; D009593:Nitroimidazoles / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D012698:Serologic Tests; D016896:Treatment Outcome; D014349:Trypanosoma cruzi / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000913:Antibodies, Protozoan; D009593:Nitroimidazoles; C009999:benzonidazole