Human acute Chagas disease: changes in factor VII, activated protein C and hepatic enzymes from patients of oral outbreaks in Pará State (Brazilian Amazon)

人类急性恰加斯病:帕拉州(巴西亚马逊地区)口腔爆发患者体内的因子 VII、活性蛋白 C 和肝酶的变化

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作者:Valéria Regina Cavalcante Dos Santos, Dina Antunes, Dilma do Socorro Moraes de Souza, Otacilio Cruz Moreira, Igor Campos de Almeida Lima, Désio A Farias-de-Oliveira, João Pedro Lobo, Ernesto de Meis, José Rodrigues Coura, Wilson Savino, Angela Cristina Verissimo Junqueira, Juliana de Meis

Abstract

Oral transmission of Chagas disease has been increasing in Latin American countries. The present study aimed to investigate changes in hepatic function, coagulation factor levels and parasite load in human acute Chagas disease (ACD) secondary to oral Trypanosoma cruzi transmission. Clinical and epidemiological findings of 102 infected individuals attended in the State of Pará from October 2013 to February 2016 were included. The most common symptoms were fever (98%), asthenia (83.3%), face and limb edema (80.4%), headache (74.5%) and myalgia (72.5%). The hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of 30 ACD patients were higher compared with controls, and this increase was independent of the treatment with benznidazole. Moreover, ACD individuals had higher plasma levels of activated protein C and lower levels of factor VII of the coagulation cascade. Patients with the highest parasite load had also the most increased transaminase levels. Also, ALT and AST were associated moderately (r = 0.429) and strongly (r = 0.595) with parasite load respectively. In conclusion, the present study raises the possibility that a disturbance in coagulation and hepatic function may be linked to human ACD.

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