Lack of evidence of seronegative infection in an endemic area of Chagas disease

• Main Authors: Léa Campos de Oliveira, Tzong-Hae Lee, Ariela Mota Ferreira, Ana Luiza Bierrenbach, Marcela de Souza-Basqueira, Cláudia Di Lorenzo Oliveira, Clareci Silva Cardoso, Carlos Henrique Valente Moreira, Marcio K. Oikawa, Antonio Luiz P. Ribeiro, Michael P Busch, Ester Cerdeira Sabino
• Format: Article
• Language: English
• Published: Universidade de São Paulo 2019-02-01
• Series: Revista do Instituto de Medicina Tropical de São Paulo
• Subjects: Chagas disease; Diagnosis; Infectious diseases; Prevention and control
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652019005000602&lng=en&tlng=en
• ISSN: 1678-9946

ABSTRACT The diagnosis of Chagas disease is based on the detection of Trypanosoma cruzi (T. cruzi)-specific antibodies. Nonetheless, there is concern about the sensitivity of current serological assays due to reports of T. cruzi PCR positivity among seronegative individuals. The aim of this study was to evaluate if T. cruzi seronegative infections occur in endemic areas. We recruited 2,157 individuals that were identified as having Chagas disease in a public health system database of an endemic region in Brazil. All participants were interviewed and 2,091 had a sample collected for serological and PCR testing. From these, 149 (7.1%) had negative serological results. PCR was positive in 610 samples (31.4%) of the 1,942 seropositive samples but in none of the 149 samples from seronegative participants. True T. cruzi seronegative infections seem to be rare (95% CI 0-3.7) and should not be a concern for blood supply, which relies on antibody screening.