Screening for Chagas Disease Should Be Included in Entry-to-Care Testing for At-Risk People With Human Immunodeficiency Virus (HIV) Living in the United States

Clin Infect Dis. 2022 Sep 14;75(5):901-906. doi: 10.1093/cid/ciac154.


Chagas disease screening of at-risk populations is essential to identify infected individuals and facilitate timely treatment before end-organ damage occurs. Coinfected people with human immunodeficiency virus (PWH) are at risk for dangerous sequelae, specifically Trypanosoma cruzi reactivation disease. Recently published national recommendations indicate that at-risk PWH, particularly those from endemic areas or born to women from endemic areas, should be screened via a sensitive anti-T. cruzi IgG assay. However, immunocompromised patients with negative serologic results may warrant further investigation. Reactivation should be suspected in at-risk, untreated PWH with low CD4 cell counts presenting with acute neurologic or cardiac symptoms; these patients should be promptly evaluated and treated. One pragmatic solution to improve Chagas disease screening among PWH and thereby reduce T. cruzi-related morbidity and mortality is to incorporate Chagas disease screening into the panel of tests routinely performed during the entry-to-care evaluation for at-risk PWH.

Keywords: Trypanosoma cruzi; AIDS; Chagas disease; HIV; reactivation.

MeSH terms

  • Chagas Disease* / epidemiology
  • Female
  • HIV
  • HIV Infections* / complications
  • HIV Infections* / diagnosis
  • Humans
  • Immunoglobulin G
  • Trypanosoma cruzi*
  • United States / epidemiology


  • Immunoglobulin G