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dc.contributor.authorImwong, M*
dc.contributor.authorSnounou, G*
dc.contributor.authorPukrittayakamee, S*
dc.contributor.authorTanomsing, N*
dc.contributor.authorKim, J R*
dc.contributor.authorNandy, A*
dc.contributor.authorGuthmann, J P*
dc.contributor.authorNosten, F*
dc.contributor.authorCarlton, J*
dc.contributor.authorLooareesuwan, S*
dc.contributor.authorNair, S*
dc.contributor.authorSudimack, D*
dc.contributor.authorDay, N P J*
dc.contributor.authorAnderson, T J C*
dc.contributor.authorWhite, N J*
dc.date.accessioned2009-03-05T15:35:00Z
dc.date.available2009-03-05T15:35:00Z
dc.date.issued2007-04-01
dc.date.submitted2009-03-04
dc.identifier.citationRelapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. 2007, 195 (7):927-33 J. Infect. Dis.en
dc.identifier.issn0022-1899
dc.identifier.pmid17330781
dc.identifier.doi10.1086/512241
dc.identifier.urihttp://hdl.handle.net/10144/52373
dc.description.abstractBACKGROUND: 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.
dc.description.sponsorshipEpicentreen
dc.language.isoenen
dc.publisherInfectious Diseases Society of America and University of Chicago Pressen
dc.rightsArchived on this site with permission and copyright 2007 by the Infectious Diseases Society of Americaen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAnimalsen
dc.subject.meshAntimalarialsen
dc.subject.meshChilden
dc.subject.meshChloroquineen
dc.subject.meshDNA Primersen
dc.subject.meshHumansen
dc.subject.meshIndiaen
dc.subject.meshMalaria, Vivaxen
dc.subject.meshMyanmaren
dc.subject.meshPlasmodium vivaxen
dc.subject.meshPolymorphism, Restriction Fragment Lengthen
dc.subject.meshPrimaquineen
dc.subject.meshProtozoan Proteinsen
dc.subject.meshRecurrenceen
dc.subject.meshThailanden
dc.subject.meshTreatment Outcomeen
dc.titleRelapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.en
dc.identifier.journalThe Journal of Infectious Diseasesen
refterms.dateFOA2019-03-04T12:17:27Z
html.description.abstractBACKGROUND: 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.


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