by Watson JA, Cruz C, Barreira F, Forsyth C, Schijman AG, Peploe R, Assmus F, Naylor C, Lee J, Mehra S, Tarning J, Torrico F, Gascon J, Ortiz L, Ribeiro I, Sosa-Estani S, Tipple C, Hugonnet S, Guérin PJ, Fraisse L, Pinazo M-J, White NJ, on behalf of the E1224 and BENDITA Study Groups. The Lancet Microbe 2025, 10.1016. doi: 10.1016/j.lanmic.2025.101156
Summary: Very low blood trypomastigote densities complicate the determination of parasitological cure in Chagas disease using quantitative PCR (qPCR). The authors of this manuscript aimed to improve the statistical methodology used to analyse serial qPCR data. A secondary analysis was performed on pooled clinical and laboratory data from two prospective randomised controlled trials (E1224 and BENDITA) in Bolivian adults with chronic indeterminate Chagas disease. Treatment efficacy was estimated under a probabilistic hierarchical Bayesian model fitted to the serial blood qPCR data. In this population, once weekly benznidazole for 8 weeks or daily dosing over 4 weeks had similar efficacies as the current 8 weeks daily regimen. These results suggest that the total benznidazole dose in the standard of care regimen is excessive.