@article{fdi:010057088,
  title = {{U}ntreated human infections by {T}rypanosoma brucei gambiense are not 100% fatal},
  author = {{J}amonneau, {V}incent and {I}lboudo, {H}. and {K}abore, {J}. and {K}aba, {D}. and {K}offi, {M}. and {S}olano, {P}hilippe and {G}arcia, {A}ndr{\'e} and {C}ourtin, {D}avid and {L}aveissi{\`e}re, {C}laude and {L}ingue, {K}. and {B}uscher, {P}. and {B}ucheton, {B}runo},
  editor = {},
  language = {{ENG}},
  abstract = {{T}he final outcome of infection by {T}rypanosoma brucei gambiense, the main agent of sleeping sickness, has always been considered as invariably fatal. {W}hile scarce and old reports have mentioned cases of self-cure in untreated patients, these studies suffered from the lack of accurate diagnostic tools available at that time. {H}ere, using the most specific and sensitive tools available to date, we report on a long-term follow-up (15 years) of a cohort of 50 human {A}frican trypanosomiasis ({HAT}) patients from the {I}vory {C}oast among whom 11 refused treatment after their initial diagnosis. {I}n 10 out of 11 subjects who continued to refuse treatment despite repeated visits, parasite clearance was observed using both microscopy and polymerase chain reaction ({PCR}). {M}ost of these subjects (7/10) also displayed decreasing serological responses, becoming progressively negative to trypanosome variable antigens ({L}i{T}at 1.3, 1.5 and 1.6). {H}ence, in addition to the "classic" lethal outcome of {HAT}, we show that alternative natural progressions of {HAT} may occur: progression to an apparently aparasitaemic and asymptomatic infection associated with strong long-lasting serological responses and progression to an apparently spontaneous resolution of infection (with negative results in parasitological tests and {PCR}) associated with a progressive drop in antibody titres as observed in treated cases. {W}hile this study does not precisely estimate the frequency of the alternative courses for this infection, it is noteworthy that in the field national control programs encounter a significant proportion of subjects displaying positive serologic test results but negative results in parasitological testing. {T}hese findings demonstrate that a number of these subjects display such infection courses. {F}rom our point of view, recognising that trypanotolerance exists in humans, as is now widely accepted for animals, is a major step forward for future research in the field of {HAT}.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {N}eglected {T}ropical {D}iseases},
  volume = {6},
  numero = {6},
  pages = {e1691},
  ISSN = {1935-2735},
  year = {2012},
  DOI = {10.1371/journal.pntd.0001691},
  URL = {https://www.documentation.ird.fr/hor/fdi:010057088},
}