IDSA Recommendations for Preventing and Treating Chagas Disease (American Trypanosomiasis) in HIV-AIDS
Preventing Clinical Disease
Indication: Individuals with epidemic risk factors for Chagas disease and tested positive for antibody to T. cruzi, have not been previously treated, and do not have advanced Chagas cardiomyopathy.
• A single course of benznidazole or nifurtimox can be considered (doses and duration same as for treatment of disease). However, the efficacy of this therapy is suboptimal, and treated patients are still at risk of reactivation.
• Initiation or optimization of ART may prevent reactivation of Chagas disease
Treating Chagas Disease
Note: Treatment is effective in reducing parasitemia and preventing clinical manifestation or slowing progression in patients with acute, early-chronic, and re-activated disease. They have limited efficacy, however, in achieving parasitological cure.
Preferred Therapy for Acute, Early Chronic, and Re-Activated Disease:
• Benznidazole 5–8 mg/kg/day PO in 2 divided doses for 30–60 days
• Nifurtimox 8–10 mg/kg/day PO for 90–120 days
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