Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites
Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites
复制标题
DOI：
10.1086/512241
复制
发表时间：
2007-04-01
影响因子：
6.4
通讯作者：
White, Nicholas J.
中科院分区：
文献类型：
--
作者：
Imwong, Mallika;Snounou, Georges;White, Nicholas J.
背景间日疟原虫感染的特征是由催眠虫引起的复发。因此，治疗后寄生虫血症的复发可能是复发、复发或再感染的结果。已经假设引起复发的寄生虫将是引起原发感染的寄生虫的子集。在泰国（n = 36）的149例间日疟患者中，在开始抗疟治疗前和寄生虫血症复发时采集配对样本，其中可以排除再感染;在缅甸（n = 75）和印度（n = 38）的现场研究中采集配对样本。来自2种基因分型方法的组合遗传数据显示，大多数复发性感染患者中存在新型间日疟原虫种群（149例患者中的107例[72%][78%的泰国患者，75%的缅甸患者和63%的印度患者]）。在61%的泰国和缅甸患者和55%的印度患者中，复发感染不包含引起急性感染的寄生虫基因型。从催眠虫中出现的间日疟原虫种群通常与引起急性发作的种群不同。异源催眠虫群的激活是间日疟患者首次复发的最常见原因。
Background. Relapses originating from hypnozoites are characteristic of Plasmodium vivax infections. Thus, reappearance of parasitemia after treatment can result from relapse, recrudescence, or reinfection. It has been assumed that parasites causing relapse would be a subset of the parasites that caused the primary infection.Methods. Paired samples were collected before initiation of antimalarial treatment and at recurrence of parasitemia from 149 patients with vivax malaria in Thailand (n = 36), where reinfection could be excluded, and during field studies in Myanmar (n = 75) and India (n = 38).Results. Combined genetic data from 2 genotyping approaches showed that novel P. vivax populations were present in the majority of patients with recurrent infection (107 [72%] of 149 patients overall [78% of patients in Thailand, 75% of patients in Myanmar {Burma}, and 63% of patients in India]). In 61% of the Thai and Burmese patients and in 55% of the Indian patients, the recurrent infections contained none of the parasite genotypes that caused the acute infection.Conclusions. The P. vivax populations emerging from hypnozoites commonly differ from the populations that caused the acute episode. Activation of heterologous hypnozoite populations is the most common cause of first relapse in patients with vivax malaria.