Chagas Disease: A Parasitic Infection in an Immunosuppressed Host

Abstract

Immunosuppression is a health condition that could be intercurrent in people with T. cruzi infection, being life-threatening in many cases if not diagnosed and treated accurately. Due to the increase in life expectancy and the higher epidemiological risk of acquiring immunosuppressant infectious and non-infectious diseases, the number of people at risk of suffering from reactivation of chronic Chagas disease is increasing. This situation highlights the need of, on one hand, to make emphasis in the relevance of design and implement surveillance systems at regional and international level; and on the other hand, to promote early diagnosis and management of such potentially lethal cases through better health workers training. New diagnosis methods and treatment option, including coadjutant therapies with immunomodulators, are needed to better manage people at immunosuppressive state, in order to better address such potentially fatal health situations. In this topic, maternal-fetal transmission in case of immunosuppression and the management of severe and atypical reactivation is of special interest. In this chapter, we aim to summarize evidence existing for chronic Chagas disease management immunosuppressed individuals of different etiologies (HIV infection, neoplasia, transplant and autoimmune systemic diseases), and how to deal with reactivation in such cases.