Antigen-stimulated peripheral blood mononuclear cells from 14 patients with chronic Chagas' disease were examined for their ability to generate soluble factor(s) capable of activating human macrophages to a microbicidal state. Mononuclear cell factors (MCF) from all but one patient were capable of inducing macrophages to a state where they were able to kill trypomastigotes of Trypanosoma cruzi. Macrophage microbicidal activity against this organism was nonspecific, because it could be induced by lymphokine from PPD-positive subjects exposed to heat-killed BCG or by concanavalin A stimulation of normal donors cells. A factor(s) generated by the stimulation of mononuclear cells from normal donors by T. cruzi antigen did not induce macrophage microbicidal activity. Opsonization of the organisms with specific IgG did not alter their fate in normal macrophages, but enhanced their killing in MCF-activated cells. Induction of macrophage activation in the human system differed from the results previously described in mice in a few features: 1) Optimal microbicidal activity did not require daily addition of the soluble factors. 2) The MCF dose-response curve was shifted to lower concentrations. 3) MCF activity generated by antigen-stimulated peripheral blood lymphocytes correlates with their proliferative responses to antigen. Half of the patients showed low proliferative responses and correspondingly lower MCF activity. Mitogen responses were normal in all patients. No correlation was found between low or high responses and clinical manifestations of disease.