Oral transmission of Chagas disease has been increasing in Latin American countries. The present study aimed to investigate changes in hepatic function, coagulation factor levels and parasite load in human acute Chagas disease (ACD) secondary to oral Trypanosoma cruzi transmission. Clinical and epidemiological findings of 102 infected individuals attended in the State of Pará from October 2013 to February 2016 were included. The most common symptoms were fever (98%), asthenia (83.3%), face and limb edema (80.4%), headache (74.5%) and myalgia (72.5%). The hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of 30 ACD patients were higher compared with controls, and this increase was independent of the treatment with benznidazole. Moreover, ACD individuals had higher plasma levels of activated protein C and lower levels of factor VII of the coagulation cascade. Patients with the highest parasite load had also the most increased transaminase levels. Also, ALT and AST were associated moderately (r = 0.429) and strongly (r = 0.595) with parasite load respectively. In conclusion, the present study raises the possibility that a disturbance in coagulation and hepatic function may be linked to human ACD.

中文翻译：

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人类急性恰加斯病：来自帕拉州（巴西亚马逊）口腔暴发患者的VII因子，活化蛋白C和肝酶的变化

在拉丁美洲国家，恰加斯病的口腔传播一直在增加。本研究旨在调查继克鲁氏锥虫传播的人类急性恰加斯病（ACD）的肝功能，凝血因子水平和寄生虫负荷的变化。纳入了2013年10月至2016年2月在帕拉州接受治疗的102名感染者的临床和流行病学调查结果。最常见的症状是发烧（98％），乏力（83.3％），面部和四肢浮肿（80.4％），头痛（74.5％）和肌痛（72.5％）。30例ACD患者的肝酶丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）高于对照组，并且这种增加与苯硝唑治疗无关。此外，ACD个体的血浆中活化蛋白C的水平较高，而凝血级联因子VII的水平较低。寄生虫负荷最高的患者转氨酶水平也最高。此外，ALT和AST分别与寄生虫负荷适度（r = 0.429）和强烈（r = 0.595）相关。总之，本研究提出了凝血功能和肝功能紊乱可能与人ACD相关的可能性。