title: Clinical characteristics and outcome of 107 adult patients with chronic Chagas disease and parasitological cure criteria.
abstract: BACKGROUND
  The cure in adult patients with chronic Chagas disease and the relationship between parasitological and clinical evolution is still under debate. The aim of this study was to analyze the clinical, epidemiological and progression features of the disease in a patient population who became serologically negative either spontaneously or post-etiological treatment.
  
  
  METHODS
  We included 107 patients over 20 years old with three different confirmed reactive anti-Trypanosoma cruzi serologic tests on admission, and a minimum of two years of follow-up. Patients were assigned to clinical groups according to Kuschnir. Change of clinical group was considered a heart disease progression criterion, and seronegative conversion of two or three as parasitological cure criterion.
  
  
  RESULTS
  From 107 patients with parasitological cure, 82 had received treatment (77%) and 25 became spontaneously seronegative (23%). Forty-six (43%) and 61 (57%) patients had two and three negative serological tests, respectively. No differences in clinical groups, ECG, echocardiogram and heart disease progression were found in patients who became negative spontaneously or post-treatment. The clinical progression and ECG changes were observed in 5/107 (5%) and 11/107 (10%) respectively, in a mean of 10 years follow-up.
  
  
  CONCLUSIONS
  Adults with chronic Chagas disease can cure, mostly post-etiological treatment, but also spontaneously, showing a favourable clinical outcome.
authors.affiliation: Departamento de Cardiología, Hospital Eva Perón, San Martín, Buenos Aires, Argentina. gbertocchi@intramed.net
authors.forename: Graciela L
authors.initials: GL
authors.lastname: Bertocchi
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Vigliano
authors.forename: Bruno G
authors.initials: BG
authors.lastname: Lococo
authors.forename: Marcos A
authors.initials: MA
authors.lastname: Petti
authors.forename: Rodolfo J
authors.initials: RJ
authors.lastname: Viotti
mesh_terms: D000328:Adult; D000977:Antiparasitic Agents / Q000627:therapeutic use; D014355:Chagas Disease / Q000150:complications / Q000188:drug therapy / Q000469:parasitology*; D002908:Chronic Disease; D018450:Disease Progression; D004452:Echocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006331:Heart Diseases / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014349:Trypanosoma cruzi / Q000302:isolation & purification
chemical_list: D000977:Antiparasitic Agents
keywords: Benznidazole; Chagas disease; Disease progression; Parasitological cure; Spontaneous seroconversion; Treatment