Cargando…
Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil
Background—Patients with Chagas cardiomyopathy (CC) have high mortality, and CC is a common indication for heart transplantation (HTx) in endemic countries. Chagas disease reactivation (CDR) is common after transplantation and is likely to cause adverse outcomes unless detected and treated appropria...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559982/ https://www.ncbi.nlm.nih.gov/pubmed/32824760 http://dx.doi.org/10.3390/tropicalmed5030132 |
_version_ | 1783594985243803648 |
---|---|
author | Rossi Neto, Joao Manoel Finger, Marco Aurelio dos Santos, Carolina Casadei |
author_facet | Rossi Neto, Joao Manoel Finger, Marco Aurelio dos Santos, Carolina Casadei |
author_sort | Rossi Neto, Joao Manoel |
collection | PubMed |
description | Background—Patients with Chagas cardiomyopathy (CC) have high mortality, and CC is a common indication for heart transplantation (HTx) in endemic countries. Chagas disease reactivation (CDR) is common after transplantation and is likely to cause adverse outcomes unless detected and treated appropriately. This study reviews our experiences with HTx among patients with CC, and the use of benznidazole (BZ) before transplantation. Methods—During the 18-year period from 1996 through 2014, 70 of 353 patients who underwent HTx (19.8%) had CC, and 53 patients met the inclusion criteria. The effectiveness of prophylactic treatment with BZ (dose of 5 mg/kg/day, two times per day, for at least four weeks and for a maximum of eight weeks) was determined based on the observed reduction in the incidence of CDR during the post-HTx period. Results—Prophylactic therapy was administered to 18/53 patients (34.0%). During the follow-up period, the incidence rate of CDR in our study was 34.0% (18/53). Based on logistic regression analysis, only prophylaxis (OR = 0.12; CI 0.02–0.76; p = 0.025) was considered to protect against CDR. Conclusion—Our study suggests that the use of BZ may reduce the incidence of CDR in patients undergoing HTx and warrants further investigation in a prospective, randomized trial. |
format | Online Article Text |
id | pubmed-7559982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75599822020-10-22 Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil Rossi Neto, Joao Manoel Finger, Marco Aurelio dos Santos, Carolina Casadei Trop Med Infect Dis Article Background—Patients with Chagas cardiomyopathy (CC) have high mortality, and CC is a common indication for heart transplantation (HTx) in endemic countries. Chagas disease reactivation (CDR) is common after transplantation and is likely to cause adverse outcomes unless detected and treated appropriately. This study reviews our experiences with HTx among patients with CC, and the use of benznidazole (BZ) before transplantation. Methods—During the 18-year period from 1996 through 2014, 70 of 353 patients who underwent HTx (19.8%) had CC, and 53 patients met the inclusion criteria. The effectiveness of prophylactic treatment with BZ (dose of 5 mg/kg/day, two times per day, for at least four weeks and for a maximum of eight weeks) was determined based on the observed reduction in the incidence of CDR during the post-HTx period. Results—Prophylactic therapy was administered to 18/53 patients (34.0%). During the follow-up period, the incidence rate of CDR in our study was 34.0% (18/53). Based on logistic regression analysis, only prophylaxis (OR = 0.12; CI 0.02–0.76; p = 0.025) was considered to protect against CDR. Conclusion—Our study suggests that the use of BZ may reduce the incidence of CDR in patients undergoing HTx and warrants further investigation in a prospective, randomized trial. MDPI 2020-08-18 /pmc/articles/PMC7559982/ /pubmed/32824760 http://dx.doi.org/10.3390/tropicalmed5030132 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rossi Neto, Joao Manoel Finger, Marco Aurelio dos Santos, Carolina Casadei Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil |
title | Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil |
title_full | Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil |
title_fullStr | Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil |
title_full_unstemmed | Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil |
title_short | Benznidazole as Prophylaxis for Chagas Disease Infection Reactivation in Heart Transplant Patients: A Case Series in Brazil |
title_sort | benznidazole as prophylaxis for chagas disease infection reactivation in heart transplant patients: a case series in brazil |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559982/ https://www.ncbi.nlm.nih.gov/pubmed/32824760 http://dx.doi.org/10.3390/tropicalmed5030132 |
work_keys_str_mv | AT rossinetojoaomanoel benznidazoleasprophylaxisforchagasdiseaseinfectionreactivationinhearttransplantpatientsacaseseriesinbrazil AT fingermarcoaurelio benznidazoleasprophylaxisforchagasdiseaseinfectionreactivationinhearttransplantpatientsacaseseriesinbrazil AT dossantoscarolinacasadei benznidazoleasprophylaxisforchagasdiseaseinfectionreactivationinhearttransplantpatientsacaseseriesinbrazil |