Genetic Polymorphisms in the pvdhfr, pvmdr1, and pvdhps Genes of Plasmodium vivax in Patients at a Secondary Hospital in South Korea
1Department of Laboratory Medicine, College of medicine, The Catholic University of Korea, Seoul
2Department of Laboratory Medicine, Incheon St.Mary’s Hospital, The Catholic University of Korea, Incheon
3Department of Laboratory Medicine, Uijeongbu St.Mary’s Hospital, The Catholic University of Korea, Uijeongbu
4Division of Infectious Diseases, Department of Internal Medicine, Uijeongbu St.Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
ABSTRACT
Background: Plasmodium vivax is a major pathogen that causes malaria in South Korea. Several genetic polymorphisms in dihydrofolate reductase (pvdhfr), P. vivax multidrug resistance protein 1 (pvmdr1), and P. vivax hydroxymethylpterin pyrophosphokinase-dihydropteroate synthetase (pvdhps) genes are known to be associated with drug resistance in P. vivax. The objective of this study was to profile the known polymorphisms of P. vivax resistance genes in patients at a secondary hospital in South Korea.
Methods: A total of 12 patients with confirmed P. vivax infections were enrolled for this study. Sanger sequencing was performed for the pvdhfr, pvmdr1, and pvdhps genes to detect polymorphisms of these drug resistance genes.
Results: Each specimen had single or double polymorphism in pvdhfr. One specimen had a polymorphism in pvdhps. However, no specimen had any polymorphisms in pvmdr1. There was no strain with multi-polymorphisms exceeding double polymorphisms, which reported the geographic location of treatment failure.
Conclusion: No specimen showed chloroquine-resistance polymorphism in pvmdr1. Treatment with first-line therapy was successful. The prevalence of F57L in pvdhfr was higher than that reported previously. This change must be confirmed by further monitoring and surveillance of the strains with multi-polymorphisms.
Keywords
Drug resistance, Genetic polymorphism, Plasmodium vivax, South Korea
Figures & Tables
Table 1. CBC results of patients with confirmedP lasmodium vivax infections
|
Patient No. |
Sex |
Age (yr) |
WBC (103/μL) |
Hb (g/dL) |
PLT (103/μL) |
Neu (%) |
Lym (%) |
Mono (%) |
Eos (%) |
Baso (%) |
|
1 |
M |
22 |
3.55 |
15.1 |
42 |
81.0 |
12.0 |
6.0 |
0.0 |
1.0 |
|
2 |
M |
22 |
6.16 |
6.5 |
122 |
66.1 |
21.3 |
10.6 |
1.8 |
0.2 |
|
3 |
M |
64 |
2.56 |
15.1 |
63 |
78.0 |
12.0 |
8.0 |
0 |
2.0 |
|
4 |
F |
50 |
2.40 |
13.1 |
65 |
81.2 |
12.3 |
5.7 |
0.5 |
0.3 |
|
5 |
M |
57 |
5.39 |
9.4 |
28 |
86.0 |
6.0 |
8.0 |
0.0 |
0.0 |
|
6 |
M |
64 |
3.51 |
13.8 |
53 |
82.0 |
13.0 |
3.0 |
1.0 |
1.0 |
|
7 |
M |
23 |
5.00 |
11.7 |
64 |
93.0 |
2.0 |
4.0 |
0.0 |
1.0 |
|
8 |
M |
22 |
6.48 |
13.6 |
107 |
49.0 |
38.0 |
12.0 |
1.0 |
0.0 |
|
9 |
F |
68 |
4.96 |
11.8 |
31 |
92.0 |
1.0 |
2.0 |
0.0 |
0.0 |
|
10 |
M |
29 |
4.15 |
15.6 |
40 |
51.9 |
20.8 |
18.0 |
6.5 |
2.8 |
|
11 |
M |
53 |
1.28 |
13.8 |
16 |
62.0 |
31.0 |
2.0 |
1.0 |
0.0 |
|
12 |
M |
43 |
1.67 |
15.5 |
26 |
80.0 |
20.0 |
0.0 |
0.0 |
0.0 |
|
Abbreviations: CBC, complete blood count; WBC, white blood cells; Hb, hemoglobin; PLT, platelets; Neu, neutrophils; Lym, lymphocytes; Mono, monocytes; Eos, eosinophils; Baso, basophils; M, male; F,female. |
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