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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | de Pina-Costa, Anielle Silvino, Ana Carolina Rios dos Santos, Edwiges Motta Pedro, Renata Saraiva Moreira, José Umana, Gabriela Liseth da Silva, Ana Danielle Tavares da Rosa Santos, Otília Helena Lupi de Deus Henriques, Karina Medeiros Daniel-Ribeiro, Cláudio Tadeu Brasil, Patrícia Sousa, Tais Nobrega Siqueira, André M. |
| Abstract | Background The relapsing nature of Plasmodium vivax infection is a major barrier to its control and elimination. Factors such as adequate dosing, adherence, drug quality, and pharmacogenetics can impact the effectiveness of radical cure of P. vivax and need to be adequately evaluated. CYP2D6 pathway mediates the activation of primaquine (primaquine) into an active metabolite(s) in hepatocytes, and impaired activity has been linked to a higher risk of relapse. Cases presentation Three patients diagnosed with P. vivax malaria presented repeated relapses after being initially treated with chloroquine (25 mg/kg) and primaquine (3.5 mg/kg in 14 days) at a non-endemic travel clinic. Recurring episodes were subsequently treated with a higher dose of primaquine (7 mg/kg in 14 days), which prevented further relapses in two patients. However, one patient still presented two episodes after a higher primaquine dose and was prescribed 300 mg of chloroquine weekly to prevent further episodes. Impaired CYP2D6 function was observed in all of them. Conclusion Lack of response to primaquine was associated with impaired CYP2D6 activity in three patients presenting multiple relapses followed in a non-endemic setting. Higher primaquine dosage was safe and effectively prevented relapses in two patients and should be further investigated as an option in Latin America. It is crucial to investigate the factors associated with unsuccessful radical cures and alternative therapeutic options. |
| Related Links | https://malariajournal.biomedcentral.com/counter/pdf/10.1186/s12936-021-03869-x.pdf |
| Ending Page | 6 |
| Page Count | 6 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14752875 |
| DOI | 10.1186/s12936-021-03869-x |
| Journal | Malaria Journal |
| Issue Number | 1 |
| Volume Number | 20 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2021-08-14 |
| Access Restriction | Open |
| Subject Keyword | Parasitology Tropical Medicine Infectious Diseases Entomology Microbiology Public Health Plasmodium vivax Relapses CYP2D6 Primaquine Radical cure |
| Content Type | Text |
| Resource Type | Case study |
| Subject | Infectious Diseases Parasitology |
| Journal Impact Factor | 2.4/2023 |
| 5-Year Journal Impact Factor | 2.6/2023 |
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