Revisiting the Posttherapeutic Cure Criterion in Chagas Disease: Time for New Methods, More Questions, Doubts, and Polemics or Time to Change Old Concepts?

Table 1

Laboratorial methods used for posttherapeutic cure criteria in human Chagas disease and Trypanosoma cruzi infection in experimental models.

Conventional serological tests	Nonconventional serological tests	Parasitological test	Interpretation
(CFR, IHA, IIF, and ELISA)	(ML, FC-ALTA, FC-AFEA, and FC-ATE)	(Direct test, indirect tests, and PCR)
POS	POS	POS	Not cured
NEG	NEG	NEG	Cured (classic criterion)
POS	NEG	NEG	Dissociated/cured (Krettli and Brener criterion)
POS/NEG	POS/NEG	NEG	Oscillating/inconclusive

Conventional serological tests: CFR (complement fixation reaction); IHA (indirect hemagglutination assay); IIF (indirect Immunofluorescence test), and ELISA (enzyme-linked immunosorbent assay); nonconventional serological tests: ML (complement mediated lysis); FC-ALTA (flow cytometry anti-live trypomastigotes antibodies); FC-AFEA (flow cytometry anti-fixed epimastigotes antibodies); FC-ATE (flow cytometry anti-live amastigote/trypomastigotes and fixed epimastigote antibodies); direct parasitological tests: fresh blood examination (FBE), trypomastigotes concentration (buffy coat, microhematocrit, and Strout tests); indirect parasitological tests: xenodiagnosis, hemoculture, and PCR.