期刊
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
卷 88, 期 6, 页码 1116-1123出版社
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.12-0701
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资金
- U.S. Department of Defense Global Emerging Infections Surveillance and Response System Program
- National Institutes of Health [AI089819]
- NIH Infectious Disease Pathogenesis Research Training Grant [5T32AI0715132]
- North Carolina Clinical and Translational Science Award [UL1RR025747]
Plasmodium vivax accounts for an increasing fraction of malaria infections in Thailand and Cambodia. We compared P. vivax genetic complexity and antimalarial resistance patterns in the two countries. Use of a heteroduplex tracking assay targeting the merozoite surface protein 1 gene revealed that vivax infections in both countries are frequently polyclonal (84%), with parasites that are highly diverse (H-E = 0.86) but closely related (G(ST) = 0.18). Following a history of different drug policies in Thailand and Cambodia, distinct patterns of antimalarial resistance have emerged: most Cambodian isolates harbor the P. vivax multidrug resistance gene 1 (pvmdr1) 976F mutation associated with chloroquine resistance (89% versus 8%, P < 0.001), whereas Thai isolates more often display increased pvmdr1 copy number (39% versus 4%, P < 0.001). Finally, genotyping of paired isolates from individuals suspected of suffering relapse supports a complex scheme of relapse whereby recurrence of multiple identical variants is sometimes accompanied by the appearance of novel variants.
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