Abstract
The molecular and serological methods available for Discrete Typing Units (DTU)-specific diagnosis of Trypanosoma cruzi in chronic Chagas disease present limitations. The study evaluated the performance of Human Chagas-Flow ATE-IgG1 for universal and DTU-specific diagnosis of Chagas disease. A total of 102 sera from Chagas disease patients (CH) chronically infected with TcI, TcVI or TcII DTUs were tested for IgG1 reactivity to amastigote/(A), trypomastigote/(T) and epimastigote/(E) antigens along the titration curve (1:250–1:32,000). The results demonstrated that “AI 250/40%”, “EVI 250/30%”, “AII 250/40%”, “TII 250/40%” and “EII 250/30%” have outstanding accuracy (100%) to segregate CH from non-infected controls. The attributes “TI 4,000/50%”, “EI 2,000/50%”, “AVI 8,000/60%” and “TVI 4,000/50%” were selected for DTU-specific serotyping of Chagas disease. The isolated use of “EI 2,000/50%” provided the highest co-positivity for TcI patients (91%). The combined decision tree algorithms using the pre-defined sets of attributes showed outstanding full accuracy (92% and 97%) to discriminate “TcI vs TcVI vs TcII” and “TcI vs TcII” prototypes, respectively. The elevated performance of Human Chagas-Flow ATE-IgG1 qualifies its use for universal and TcI/TcVI/TcII-specific diagnosis of Chagas disease. These findings further support the application of this method in epidemiological surveys, post-therapeutic monitoring and clinical outcome follow-ups for Chagas disease.
Highlights
The molecular and serological methods available for Discrete Typing Units (DTU)-specific diagnosis of Trypanosoma cruzi in chronic Chagas disease present limitations
Based on the molecular data, the Chagas disease patients (CH) group was further categorized into three subgroups, according to the T. cruzi DTU infection, including: patients infected with TcI, from both genders, age > 18 years old, residents of Bogotá, Colombia (TcI infection, n = 35); patients infected with TcVI, from both genders, age > 18 years old, residents of Berilo, Jequitinhonha Valley, Minas Gerais, Brazil (TcVI infection, n = 07) and patients infected with TcII, from both genders, age > 18 years old, residents of Berilo (n = 45) and Bambui (n = 15), Minas Gerais, Brazil (TcII infection, n = 60)
The results demonstrated that the pairs of attributes “AI 250”, “TI 250”, “EI 250”, “AVI 250”, “TVI 250”, “EVI 250”, “AII 250”, “TII 250” and “EII 250” presented the highest delta reactivity to segregated CH from non-infected controls (NI) (Fig. 1)
Summary
The molecular and serological methods available for Discrete Typing Units (DTU)-specific diagnosis of Trypanosoma cruzi in chronic Chagas disease present limitations. The elevated performance of Human Chagas-Flow ATE-IgG1 qualifies its use for universal and TcI/TcVI/TcII-specific diagnosis of Chagas disease These findings further support the application of this method in epidemiological surveys, post-therapeutic monitoring and clinical outcome follow-ups for Chagas disease. Geographical distribution of T. cruzi DTUs, the genetic variability is associated with distinct parasite biological behaviors, influencing the Chagas disease clinical outcome as well as the response to etiological treatment[6,7,8,9,10,11,12,13,14,15] In this sense, the DTU-specific diagnosis of Chagas disease is a relevant approach for epidemiological surveillance underlying precise strategies for disease control and as a reliable laboratorial tool for clinical prognosis and post therapeutic m anagement[16,17]
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