Etiological treatment of chronic Chagas disease: neglected 'evidence' by evidence-based medicine

被引：55
作者：
Viotti, Rodolfo [1 ]
Vigliano, Carlos
机构：
[1] Hosp Eva Peron, Chagas Dis Sect, Buenos Aires, DF, Argentina
[2] Favaloro Fdn, Inst Cardiol & Cardiovasc Surg, Buenos Aires, DF, Argentina
来源：
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY | 2007年 / 5卷 / 04期
关键词：
Chagas disease; diagnosis; etiological treatment; pathogenesis; pathology; prognosis; TRYPANOSOMA-CRUZI DNA; POLYMERASE-CHAIN-REACTION; HEART-DISEASE; PARASITE PERSISTENCE; INFLAMMATORY INFILTRATE; CONGENITAL TRANSMISSION; CLINICAL PREDICTORS; EARLY-DIAGNOSIS; PUBLIC-HEALTH; CHRONIC PHASE;
D O I：
10.1586/14787210.5.4.717
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
No randomized clinical trials regarding the etiological treatment of chronic Chagas disease can be found in the medical literature. However, other 'evidence' sustaining the use of anti-Trypanosoma cruzi drugs for adult individuals with Chagas disease will be analyzed along with the limitations in evaluating the treatment efficacy. Today, the hypothesis of T cruzi persistence in the target organs giving rise to the chronic inflammatory response is sustained. In addition, several experimental, pathological, nonrandomized clinical studies and studies based on the response or serological evolution (besides the clinical experience) demonstrate the role of T cruzi in the pathogenesis of the chronic stage and the efficacy of etiological treatment to reduce the titers of antibodies and the progression of chronic Chagas heart disease. All of this supports the recommendation of treatment for every patient diagnosed with Chagas disease. The interpretation of this sum of evidence is not considered from the perspective of evidence-based medicine.
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收藏
页码：717 / 726
页数：10
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