Course of serological tests in treated subjects with chronic Trypanosoma cruzi infection: A systematic review and meta-analysis of individual participant data

• Published in: International journal of infectious diseases Vol. 73; pp. 93 - 101
• Main Authors: Sguassero, Yanina, Roberts, Karen N., Harvey, Guillermina B., Comandé, Daniel, Ciapponi, Agustín, Cuesta, Cristina B., Aguiar, Camila, Castro, Ana M. de, Danesi, Emmaría, de Andrade, Ana L., de Lana, Marta, Escribà, Josep M., Fabbro, Diana L., Fernandes, Cloé D., Flores-Chávez, María, Hasslocher-Moreno, Alejandro M., Jackson, Yves, Lacunza, Carlos D., Machado-de-Assis, Girley F., Maldonado, Marisel, Meira, Wendell S.F., Molina, Israel, Monje-Rumi, María M., Muñoz-San Martín, Catalina, Murcia, Laura, Nery de Castro, Cleudson, Sánchez Negrette, Olga, Segovia, Manuel, Silveira, Celeste A.N., Solari, Aldo, Steindel, Mário, Streiger, Mirtha L., Vera de Bilbao, Ninfa, Zulantay, Inés, Sosa-Estani, Sergio
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.08.2018; Elsevier
• Subjects: Adolescent; Adult; analysis; Antibodies, Protozoan - blood; Chagas Disease - diagnosis; Child; Child, Preschool; Chronic Disease; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique, Indirect; Follow-up studies; Hemagglutination Tests; Humans; Individual participant data; Infant; Male; Meta; Serologic Tests; Trypanosoma cruzi; Young Adult; Meta; Serologic tests; Individual participant data; Chronic disease; analysis; Follow-up studies; Trypanosoma cruzi
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2018.05.019

•This is the first meta-analysis of individual data in chronic Trypanosoma cruzi infection after treatment.•The probability of seroreversion is variable along the course of follow-up.•An interaction was found between age at treatment and country setting.•The course of parasitological/molecular tests after treatment needs to be assessed. To determine the course of serological tests in subjects with chronic Trypanosoma cruzi infection treated with anti-trypanosomal drugs. 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). 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. 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.