Effects of mefloquine use on Plasmodium vivax multidrug resistance

Numerous studies have indicated a strong association between amplification of the multidrug resistance-1 gene and in vivo and in vitro mefloquine resistance of Plasmodium falciparum. Although falciparum infection usually is not treated with mefloquine, incorrect diagnosis, high frequency of undetect...

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Published in:Emerging infectious diseases 2014-10, Vol.20 (10), p.1637-1636
Main Authors: Khim, Nimol, Andrianaranjaka, Voahangy, Popovici, Jean, Kim, Saorin, Ratsimbasoa, Arsene, Benedet, Christophe, Barnadas, Celine, Durand, Remy, Thellier, Marc, Legrand, Eric, Musset, Lise, Menegon, Michela, Severini, Carlo, Nour, Bakri Y M, Tichit, Magali, Bouchier, Christiane, Mercereau-Puijalon, Odile, Ménard, Didier
Format: Article
Language:English
Subjects:
Cambodia - epidemiology
copy number
drug resistance
Drug Resistance - drug effects
French Guiana - epidemiology
Gene Expression Regulation - drug effects
Humans
Life Sciences
Madagascar - epidemiology
malaria
Malaria, Falciparum - epidemiology
Malaria, Falciparum - parasitology
Malaria, Vivax - epidemiology
Malaria, Vivax - parasitology
mdr-1 gene
mefloquine
Mefloquine - therapeutic use
Microbiology and Parasitology
Multidrug Resistance-Associated Proteins - genetics
Multidrug Resistance-Associated Proteins - metabolism
Parasitology
Pharmaceutical sciences
Pharmacology
Plasmodium falciparum - drug effects
Plasmodium vivax
Plasmodium vivax - drug effects
Protozoan Proteins - genetics
Protozoan Proteins - metabolism
Sudan - epidemiology
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Summary:Numerous studies have indicated a strong association between amplification of the multidrug resistance-1 gene and in vivo and in vitro mefloquine resistance of Plasmodium falciparum. Although falciparum infection usually is not treated with mefloquine, incorrect diagnosis, high frequency of undetected mixed infections, or relapses of P. vivax infection triggered by P. falciparum infections expose non-P. falciparum parasites to mefloquine. To assess the consequences of such unintentional treatments on P. vivax, we studied variations in number of Pvmdr-1 (PlasmoDB accession no. PVX_080100, NCBI reference sequence NC_009915.1) copies worldwide in 607 samples collected in areas with different histories of mefloquine use from residents and from travelers returning to France. Number of Pvmdr-1 copies correlated with drug use history. Treatment against P. falciparum exerts substantial collateral pressure against sympatric P. vivax, jeopardizing future use of mefloquine against P. vivax. A drug policy is needed that takes into consideration all co-endemic species of malaria parasites.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid2010.140411