Regional Variation in the Correlation of Antibody and T-Cell Responses to Trypanosoma cruzi

Diana L. Martin Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Morgan Marks Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Gerson Galdos-Cardenas Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Robert H. Gilman Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Brook Goodhew Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Lisbeth Ferrufino Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Anthony Halperin Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Gerardo Sanchez Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Manuela Verastegui Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Patricia Escalante Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Cesar Naquira Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Michael Z. Levy Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Caryn Bern Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú

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Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a major cause of morbidity and mortality in Central and South America. Geographic variations in the sensitivity of serologic diagnostic assays to T. cruzi may reflect differences in T. cruzi exposure. We measured parasite-specific T-cell responses among seropositive individuals in two populations from South America with widely varying antibody titers against T. cruzi. Antibody titers among seropositive individuals were significantly lower in Arequipa, Peru compared with Santa Cruz, Bolivia. Similarly, the proportion of seropositive individuals with positive T-cell responses was lower in Peru than Bolivia, resulting in overall lower frequencies of interferon-γ (IFNγ)-secreting cells from Peruvian samples. However, the magnitude of the IFNγ response was similar among the IFNγ responders in both locations. These data indicate that immunological discrepancies based on geographic region are reflected in T-cell responses as well as antibody responses.

Author Notes

* Address correspondence to Diana L. Martin, Division of Parasitic Diseases and Malaria, MS D-65, 1600 Clifton Road NE, Centers for Disease Control and Prevention, Atlanta, GA 30329. E-mail: hzx3@cdc.gov
† Deceased.

Financial support: This work was funded by National Institutes of Health Tropical Medical Research Center Grant P50 AI074285 and National Institutes of Health Fogarty Scholars Program Grant R24 TW007988.

Authors' addresses: Diana L. Martin and Brook Goodhew, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: hz3@cdc.gov and isd6@cdc.gov. Morgan Marks, Merck and Co., Whitehouse Station, NJ, E-mail: mmarkster@gmail.com. Gerson Galdos-Cardenas and Lisbeth Ferrufino, Hospital Universitario Japones, Santa Cruz, Bolivia, and Asociación Benéfica PRISMA, Lima, Peru, E-mails: gerson_galdos@yahoo.es and lisbeth_ferrufino@yahoo.es. Robert H. Gilman, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, E-mail: gilmanabob@gmail.com. Gerardo Sanchez and Manuela Verastegui, Universidad Peruana Cayetano Heredia, Lima, Perú, E-mails: gjsg2@hotmail.com and mveraste@jhsph.edu. Patricia Escalante, Universidad Peruana Cayetano Heredia, Arequipa, Perú, E-mail: patriciaeem2008@gmail.com. Cesar Naquira, Arequipa Ministry of Health, Arequipa, Peru, E-mail: cesar.naquira@gmail.com. Michael Z. Levy, University of Pennsylvania, Philadelphia, PA, E-mail: mzlevy@mail.med.upenn.edu. Caryn Bern, University of California, San Francisco, CA, E-mail: Caryn.Bern2@ucsf.edu.

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