Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC, USA.
Pulmonary Division, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, SP, Brazil.
Curr Cardiol Rep. 2024 Oct;26(10):1105-1112. doi: 10.1007/s11886-024-02113-7. Epub 2024 Aug 8.
This review seeks to describe the updates in the literature - particularly with regards to the epidemiology and diagnosis of Chagas disease. Additionally, this paper describes updates to the antiparasitic treatment for Chagas disease.
With regards to changing epidemiology, autochthonous cases are being found within the USA in addition to Latin America. Additionally, there appears to be more intermixing of discrete typing units-meaning, they are not confined to specific geographic regions. Screening for Chagas disease is recommended in persons who lived in areas with endemic Chagas, persons wtih family member diagnosed with Chagas Disease, persons who have lived in homes of natural material in Latin America, and persons with history of kissing bug bites. Treatment for the parasitic infection remains limited to benznidazole and nifurtimox, and the role of these treatments in Chagas cardiomyopathy has not yet been definitively defined. Finally, indications for and management of heart transplant in the setting of Chagas disease are discussed.
Use of antiparasitics during chronic chagas disease should be further explored. Additionally, future research identifying other markers of infection would be valuable to defining cure from infection.
本篇综述旨在描述有关克氏锥虫病的文献更新，特别是流行病学和诊断方面的更新。此外，本文还介绍了克氏锥虫病驱虫治疗的更新。
在拉丁美洲以外的美国，也发现了土生土长的病例。此外，离散型单元似乎有更多的混合，这意味着它们不再局限于特定的地理区域。建议对以下人群进行克氏锥虫病筛查：居住在克氏锥虫病流行地区的人、有确诊克氏锥虫病家族成员的人、居住在拉丁美洲天然材料房屋中的人、有接吻虫叮咬史的人。寄生虫感染的治疗仍然局限于苯并咪唑和硝呋莫司，这些治疗方法在克氏锥虫心肌病中的作用尚未明确界定。最后，讨论了克氏锥虫病患者心脏移植的适应证和处理。
应进一步探索慢性克氏锥虫病期间使用驱虫药物的情况。此外，发现其他感染标志物的未来研究对于确定从感染中治愈将是有价值的。
