Bea-Serrano Carlos, de Gracia-León Ana Isabel, Llenas-García Jara, Vela-Bernal Sara, Belmonte-Domingo Andreu, Pinto-Pla Carolina, Ferrer-Ribera Ana, Galindo María José, Alcaraz María Jesús, Oltra Sempere María Rosa
Infectious Disease Unit, Internal Medicine Department, Clinic University Hospital of Valencia, 46010 Valencia, Spain.
INCLIVA Biomedical Research Institute, 46010 Valencia, Spain.
Trop Med Infect Dis. 2025 Jun 11;10(6):161. doi: 10.3390/tropicalmed10060161.
This retrospective cohort study aimed to assess clinical and epidemiological characteristics, treatment outcomes, and predictors of serological cure in patients with chronic Chagas disease in a non-endemic setting. All individuals aged ≥16 years with confirmed infection and evaluated at a tertiary hospital in Spain from 2008 to 2023 were included. Most of the 107 participants were women (78.5%) and Bolivian-born (99.1%). Digestive and cardiac involvement were identified in 32.7% and 17.8% of cases, respectively. Cardiac symptoms were significantly associated with the diagnostic findings of cardiac involvement (odds ratio [OR] 3.0, 95% confidence interval [CI] 1.1-8.2), whereas digestive symptoms did not correlate with imaging abnormalities (OR 0.7, 95% CI 0.3-1.6). Antiparasitic treatment, usually benznidazole, was initiated in 69% of patients and led to adverse events in 66.2%, with treatment discontinuation in 25.7%. Only 8.1% of treated patients achieved serological cure after a median 26 months, with obesity emerging as the only independent predictor (adjusted OR 31.0, 95% CI 3.7-261.2). Cardiac progression occurred in 9.3% of patients despite treatment. Although 59.8% were lost to follow-up, the cohort maintained a median follow-up of 27 months. These findings underscore the need for improved treatment strategies and sustained clinical monitoring in non-endemic settings.
这项回顾性队列研究旨在评估非流行地区慢性恰加斯病患者的临床和流行病学特征、治疗结果以及血清学治愈的预测因素。纳入了2008年至2023年在西班牙一家三级医院确诊感染并接受评估的所有年龄≥16岁的个体。107名参与者中大多数为女性（78.5%）且出生于玻利维亚（99.1%）。分别在32.7%和17.8%的病例中发现有消化系统和心脏受累。心脏症状与心脏受累的诊断结果显著相关（比值比[OR] 3.0，95%置信区间[CI] 1.1 - 8.2），而消化系统症状与影像学异常不相关（OR 0.7，95% CI 0.3 - 1.6）。69%的患者开始接受抗寄生虫治疗，通常为苯硝唑，66.2%出现不良事件，25.7%中断治疗。在接受治疗的患者中，中位26个月后只有8.1%实现血清学治愈，肥胖是唯一的独立预测因素（调整后OR 31.0，95% CI 3.7 - 261.2）。尽管接受了治疗，9.3%的患者仍出现心脏病变进展。虽然59.8%的患者失访，但该队列的中位随访时间为27个月。这些发现强调了在非流行地区需要改进治疗策略并持续进行临床监测。
