Genetic epidemiology of Trypanosoma cruzi infection and Chagas' disease

Chagas' disease is a leading cause of heart disease throughout Latin America, affecting an estimated 16 to 18 million individuals. Given the large pool of primary hosts for this zoonotic disease, complete eradication of Chagas' disease through control of the arthropod vector is unlikely. Research with both humans and animal models indicates that there is considerable variation in susceptibility to infection and disease outcome, and that this variation may be due in part to genetic factors. This paper summarizes the evidence for genetic control of susceptibility to Trypanosoma cruzi infection and severity of disease outcome in Chagas' disease. The lack of an effective treatment or prevention for Chagas' disease indicates the great potential for genetic studies, and particularly for genome scans of extended human pedigrees, to improve our understanding of the determinants of this complex disease, and ultimately to suggest new pathways to be targeted in drug development efforts.