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Beneficial effects of benznidazole in Chagas disease: NIH SaMi-Trop cohort study
- Cardoso, Clareci Silva;
- Ribeiro, Antonio Luiz P;
- Di Lorenzo Oliveira, Claudia;
- Oliveira, Lea Campos;
- Ferreira, Ariela Mota;
- Bierrenbach, Ana Luiza;
- Silva, José Luiz Padilha;
- Colosimo, Enrico Antonio;
- Ferreira, João Eduardo;
- Lee, Tzong-Hae;
- Busch, Michael P;
- Reingold, Arthur Lawrence;
- Sabino, Ester Cerdeira
- Editor(s): Almeida, Igor C
- et al.
Published Web Location
https://doi.org/10.1371/journal.pntd.0006814Abstract
Background
The effectiveness of anti-parasite treatment with benznidazole in the chronic Chagas disease (ChD) remains uncertain. We evaluated, using data from the NIH-sponsored SaMi-Trop prospective cohort study, if previous treatment with benznidazole is associated with lower mortality, less advanced cardiac disease and lower parasitemia in patients with chronic ChD.Methods
The study enrolled 1,959 ChD patients and abnormal electrocardiogram (ECG) from in 21 remote towns in Brazil. A total of 1,813 patients were evaluated at baseline and after two years of follow-up. Those who received at least one course of benznidazole were classified as treated group (TrG = 493) and those who were never treated as control group (CG = 1,320). The primary outcome was death after two-year follow-up; the secondary outcomes were presence at the baseline of major ChD-associated ECG abnormalities, NT-ProBNP levels suggestive of heart failure, and PCR positivity.Results
Mortality after two years was 6.3%; it was lower in the TrG (2.8%) than the CG (7.6%); adjusted OR: 0.37 (95%CI: 0.21;0.63). The ECG abnormalities typical for ChD and high age-adjusted NT-ProBNP levels suggestive of heart failure were lower in the TrG than the CG, OR: 0.35 [CI: 0.23;0.53]. The TrG had significantly lower rates of PCR positivity, OR: 0.35 [CI: 0.27;0.45].Conclusion
Patients previously treated with benznidazole had significantly reduced parasitemia, a lower prevalence of markers of severe cardiomyopathy, and lower mortality after two years of follow-up. If used in the early phases, benznidazole treatment may improve clinical and parasitological outcomes in patients with chronic ChD.Trial registration
ClinicalTrials.gov, Trial registration: NCT02646943.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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