Activation of minority-variant Plasmodium vivax hypnozoites following artesunate + amodiaquine treatment in a 23-year old man with relapsing malaria in Antananarivo, Madagascar Public Deposited

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Creator
  • Lin, Jessica T
    • Affiliation: School of Medicine, Division of Infectious Diseases, Department of Medicine
  • Golden, Christopher
    • Other Affiliation: Harvard University Center for the Environment, Cambridge, MA, USA; Madagascar Health and Environmental Research (MAHERY), Maroantsetra, Madagascar
  • Juliano, Jonathan
    • Affiliation: School of Medicine, Division of Infectious Diseases, Department of Medicine
  • Randrianarivelojosia, Milijaona
    • Other Affiliation: Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
  • Andrianaranjaka, Voahangy
    • Other Affiliation: Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
Abstract
  • Abstract: In endemic areas, Plasmodium vivax relapses are difficult to distinguish from new infections. Genotyping of patients who experience relapse after returning to a malaria-free area can be used to explore the nature of hypnozoite activation and relapse. This paper describes a person who developed P. vivax malaria for the first time after travelling to Boriziny in the malaria endemic coastal area of Madagascar, then suffered two P. vivax relapses 11 weeks and 21 weeks later despite remaining in Antananarivo in the malaria-free central highlands area. He was treated with the combination artesunate + amodiaquine according to the national malaria policy in Madagascar. Genotyping by PCR-RFLP at pvmsp-3α as well as pvmsp1 heteroduplex tracking assay (HTA) showed the same dominant genotype at each relapse. Multiple recurring minority variants were also detected at each relapse, highlighting the propensity for multiple hypnozoite clones to activate simultaneously to cause relapse.
Date of publication
Identifier
  • doi:10.1186/1475-2875-12-177
  • 23721298
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Voahangy Andrianaranjaka et al.; licensee BioMed Central Ltd.
License
Journal title
  • Malaria Journal
Journal volume
  • 12
Journal issue
  • 1
Page start
  • 177
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1475-2875
Bibliographic citation
  • Malaria Journal. 2013 May 31;12(1):177
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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