ACUTE-PHASE PROTEINS AND SEROLOGIC PROFILES OF CHAGASIC CHILDREN FROMAN ENDEMIC AREA IN BOLIVIA

Chagas' disease represents a major public health problem in Latin Amer ica. In endemic areas, it is important to detect acute and even asympt omatic infections in children so that specific therapy can be started immediately. We studied 203 sera from children from the region of Coch abamba, Bolivia. A high percentage of seropositive individuals was fou nd in the three villages studied. Levels of alpha-2 macroglobulin (A2M ) and C-reactive protein (CRP) increased in a significant number of ch ildren with acute Chagas' disease, The combined analysis of serologic and biochemical parameters can define the different stages of acute in fection by Trypanosoma cruzi: 1) an early stage, with an increase only in specific immunoglobulin M (IgM) levels; 2) intermediate stages, wi th high specific IgM and IgG levels and/or high anti-galactose (anti-G al) levels and increased A2M and/or CRP levels; and 3) a late acute st age, with low IgM levels but high A2M, CRP, anti-Gal, and specific IgG levels. The detection of high IgG levels alone is indicative of the c hronic/indeterminate stage of Chagas' disease, We also show serologic differences between seropositive asymptomatic villagers and symptomati c patients undergoing medical care; asymptomatic cases presented highe r levels of A2M and lower levels of specific antibodies.