Chagas disease, caused by the parasite Trypanosoma cruzi (T. cruzi), remains a significant public health concern, particularly in Latin America. However, due to globalization and migration, cases are increasingly detected in non-endemic regions, including the United States.¹ Early and accurate diagnosis is crucial, especially for immunocompromised individuals such as solid organ transplant (SOT) recipients, who are at high risk for severe complications due to T. cruzi reactivation.

Chagas Disease Diagnostic Options

Traditional diagnostic methods for Chagas disease include serology, which detects antibodies against T. cruzi, and microscopy, which identifies the parasite in blood smears. While serology is effective for chronic infection diagnosis, it is not ideal for detecting early-stage or reactivated infections in immunocompromised patients.

Screening for Chagas disease transmission from an infected donor or the reactivation of chronic or indeterminate Chagas post-transplant is recommended. Molecular testing using polymerase chain reaction (PCR) provides a more sensitive and reliable method for the early detection of the disease.²

Clinical benefits of PCR Testing

PCR testing offers clinical benefits for detecting acute T. cruzi infection, particularly among immunocompromised individuals and solid organ transplant recipients:

• PCR is the preferred method for detecting cruzi in the acute phase of infection, especially in cases of reactivation where antibody responses may be weak or absent¹
• Among SOT recipients, PCR can detect cruzi reactivation before clinical symptoms appear²
• PCR detection of cruzi in solid organ transplant recipients can help facilitate treatment adjustments, preventing disease progression³
• PCR is a reliable tool for early diagnosis⁴ and has been validated by a multicenter study for its high sensitivity and specificity for detecting cruzi DNA in blood sample.

The Future of Chagas Disease Diagnostics

As research and technology continue to advance, diagnostic assays similar to those offered by Eurofins Viracor are becoming essential tools in infectious disease management. The integration of PCR testing into routine clinical practice for high-risk populations can help improve early detection, enable timely treatment, and may help contribute to the reduction of the morbidity and mortality associated with Chagas disease.

References:

1. Centers for Disease Control and Prevention (CDC). "Chagas Disease." https://www.cdc.gov/parasites/chagas/
2. La Hoz RM, Morris MI; Infectious Diseases Community of Practice of the American Society of Transplantation. "Tissue and blood protozoa including toxoplasmosis, Chagas disease, leishmaniasis, Babesia, Acanthamoeba, Balamuthia, and Naegleria in solid organ transplant recipients—Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice." Clin Transplant. 2019;33:e13546.
3. Bern C, Kjos S, Yabsley MJ, Montgomery SP. Trypanosoma cruzi and Chagas' Disease in the United States. Clin Microbiol Rev. 2011 Oct;24(4):655-81. doi: 10.1128/CMR.00005-11. PMID: 21976603; PMCID: PMC3194829.
4. Qvarnstrom Y, Schijman AG, Veron V, Aznar C, Steurer F, da Silva AJ. Sensitive and specific detection of Trypanosoma cruzi DNA in clinical specimens using a multi-target real-time PCR approach. PLoS Negl Trop Dis. 2012;6(7):e1689. doi: 10.1371/journal.pntd.0001689. Epub 2012 Jul 3. PMID: 22802973; PMCID: PMC3389027.

Chagas T.cruzi qPCR
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Chagas T.cruzi qPCR