Estimating true antimalarial efficacy by heteroduplex tracking assay in patients with complex Plasmodium falciparum infections
Estimating true antimalarial efficacy by heteroduplex tracking assay in patients with complex Plasmodium falciparum infections
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DOI：
10.1128/aac.00902-06
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发表时间：
2007-02-01
影响因子：
4.9
通讯作者：
Meshnick, Steven R.
中科院分区：
文献类型：
--
作者：
Kwiek, Jesse J.;Alker, Alisa P.;Meshnick, Steven R.
异源双链追踪分析（HTAs）恶性疟原虫裂殖子表面蛋白1块-2被用来评估感染的复杂性和治疗效果在141名马拉维孕妇的三种抗疟治疗试验。感染复杂性（COI）升高与贫血、寄生虫负荷和人类免疫缺陷病毒感染相关，但与年龄或妊娠无关。治疗前后的HTA模式比较允许将30例复发性发作中的20例（66%）分类为明确的治疗失败或再感染。COI升高与治疗失败密切相关（P = 0.003）。开发了一种算法来分配10名不确定参与者的失败概率，其中一些感染共享高患病率的单一变体（> 10%）。通过汇总这些概率，估计治疗疗效。
Heteroduplex tracking assays (HTAs) of Plasmodium falciparum merozoite surface protein 1 block-2 were used to assess complexity of infection and treatment efficacy in a trial of three antimalarial treatments in 141 Malawian pregnant women. An elevated complexity of infection (COI) was associated with anemia, parasite burden, and human immunodeficiency virus infection but was not associated with age or gravidity. Comparisons of HTA patterns before and after treatment allowed the classification of 20 of 30 (66%) recurrent episodes as either definite treatment failures or reinfections. An elevated COI was strongly associated with treatment failure (P = 0.003). An algorithm was developed to assign a probability of failure for the 10 indeterminate participants, some of whose infections shared a single variant of high prevalence (> 10%). By summing these probabilities, treatment efficacy was estimated.