Presently, the treatment of the infection by Trypanosoma cruzi has been
considered unsatisfactory. The eradication of the infection and the interruption of
the chronic disease evolution have not been reached by treatment in several clinic
and experimental trials. To be unanimous, the indication of determined treatment it
should be deposed of undesirable side effects and, even if it did not produce the cure
(elimination) of the infection, it should at least stop its evolution. However, the
treatment with anti-trypanosome nitro derivatives did not show a clear advantage,
when cost and effectiveness were analyzed. Although millions of people with the
acute T. cruzi infection do not present a clinic disease, the treatment is clearly
indicated in several situations in which the patient’s life is in danger. The
controversy on the efficacy of the treatment of T. cruzi infection with the available
drugs shows that this is one of the aspects of the investigation on Chagas disease
that deserve research incentives. The suggestion that the pathogenesis of the disease
is associated to the introduction of kDNA mutations from the parasite’s genome to
the host’s defines the need of one or more drugs that are truly effective against the
infection. The persistence of the infection, throughout the life of the patient may
represent a source of kDNA which introduces cumulative mutations. The effect of
these mutations on the evolution of the disease could be avoided with the infection
elimination. Maybe, this is an aspect of scientific research with possibilities of
generating real benefits to the 18 million people infected by T. cruzi, reminding that
one third of them will present clinic manifestations of Chagas disease.
