Aetiological treatment with itraconazole or ketoconazole in individuals with Trypanosoma cruzi/HIV co-infection

Abstract

Two Brazilian cases of Trypanosoma cruzi/HIV co-infection have recently been treated with azole derivatives. Benznidazole, the drug generally used for the treatment of Chagas disease, was initially used in one case but discontinued because of an adverse effect (retrobulbar neuritis) and replaced by itraconazole. The other case had oesophageal candidiasis, which was treated with ketoconazole, a drug that had already been shown to be effective in the treatment of Chagas disease. Since the medications were effective in reducing the T. cruzi parasitaemia in both patients, they probably helped prevent the severe morbidity sometimes associated with Chagas disease, although the HIV infections still proved fatal in both cases.