Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramon y Cajal Hospital, Carretera Comenar 9.100 Km, 28034 Madrid, Spain.
Expert Rev Anti Infect Ther. 2014 Mar;12(3):357-73. doi: 10.1586/14787210.2014.880652. Epub 2014 Feb 3.
The epidemiology of Chagas disease has changed in the last decades due to migration movements, population ageing and the emergence of new transmission routes. In endemic countries, health facilities and access to healthcare are improving and T. cruzi infected patients are also benefiting from medical advances. The HIV epidemic has spread to both endemic and non-endemic areas for T. cruzi, organ transplant rates have increased recently, especially in Latin America, and other medical conditions affecting the immune system are increasing their global burden. The natural course of Chagas disease is mainly determined by the host's cellular immune response. These conditions may therefore overlap with T. cruzi infection and alter the disease's natural history which may present with atypical clinical forms and a higher associated morbidity and mortality in immunocompromised patients. The present review aims to contribute to the management of immunosuppressed patients with T. cruzi infection.
由于移民流动、人口老龄化和新的传播途径的出现，恰加斯病的流行病学在过去几十年发生了变化。在流行地区，卫生设施和医疗保健的可及性正在改善，感染 T. cruzi 的患者也受益于医疗的进步。HIV 疫情已经蔓延到 T. cruzi 的流行地区和非流行地区，器官移植率最近有所上升，特别是在拉丁美洲，其他影响免疫系统的医疗状况也在增加其在全球的负担。恰加斯病的自然病程主要取决于宿主的细胞免疫反应。因此，这些情况可能与 T. cruzi 感染重叠，并改变疾病的自然史，在免疫功能低下的患者中可能表现出不典型的临床形式和更高的相关发病率和死亡率。本综述旨在为 T. cruzi 感染的免疫抑制患者的管理提供帮助。
