Artículo de revista
Course of serological tests in treated subjects with chronic Trypanosoma cruzi infection: A systematic review and meta-analysis of individual participant data
Fecha
2018Registro en:
International Journal of Infectious Diseases 73 (2018) 93–101
10.1016/j.ijid.2018.05.019
Autor
Sguassero, Yanina
Roberts, Karen N.
Harvey, Guillermina B.
Comandé, Daniel
Ciapponi, Agustín
Cuesta, Cristina B.
Aguiar, Camila
Castro, Ana M. de
Danesi, Emmaria
Andrade, Ana L. de
Lana, Marta de
Escriba, Josep M.
Fabbro, Diana L.
Fernandes, Cloe D.
Flores Chávez, María
Hasslocher Moreno, Alejandro M.
Jackson, Yves
Lacunza, Carlos D.
Machado-de-Assis, Girley F.
Maldonado, Marisel
Meirat, Wendell S. F.
Molinau, Israel
Monje Rumiw, María M.
Muñoz San Martín, Catalina
Murcia, Laura
Castro, Cleudson Nery de
Sánchez Negrette, Olga
Segovia, Manuel
Silveira, Celeste A. N.
Solari Illescas, Aldo
Steindel, Mario
Streigerk, Mirtha L.
Vera de Bilbao, Ninfa
Zulantay Alfaro, Inés
Sosa Estani, Sergio
Institución
Resumen
Objective: To determine the course of serological tests in subjects with chronic Trypanosoma cruzi infection treated with anti-trypanosomal drugs.
Methods: A systematic review and meta-analysis was conducted using individual participant data. Survival analysis and the Cox proportional hazards regression model with random effects to adjust for covariates were applied. The protocol was registered in the PROSPERO database (http://www.crd.york.ac.uk/PROSPERO; CRD42012002162).
Results: A total of 27 studies (1296 subjects) conducted in eight countries were included. The risk of bias was low for all domains in 17 studies (63.0%). Nine hundred and thirteen subjects were assessed (149 seroreversion events, 83.7% censored data) for enzyme-linked immunosorbent assay (ELISA), 670 subjects (134 events, 80.0% censored) for indirect immunofluorescence assay (IIF), and 548 subjects (99 events, 82.0% censored) for indirect hemagglutination assay (IHA). A higher probability of seroreversion was observed within a shorter time span in subjects aged 1-19 years compared to adults. The chance of seroreversion also varied according to the country where the infection might have been acquired. For instance, the pooled adjusted hazard ratio between children/adolescents and adults for the IIF test was 1.54 (95% confidence interval 0.64-3.71) for certain countries of South America (Argentina, Bolivia, Chile, and Paraguay) and 9.37 (95% confidence interval 3.44-25.50) for Brazil.
Conclusions: The disappearance of anti-T. cruzi antibodies was demonstrated along the course of follow-up. An interaction between age at treatment and country setting was found.