Case report: recurrence of Plasmodium vivax malaria due to defective cytochrome P450 2D6 function in Pos Lenjang, Pahang, Malaysia

Mat Salleh NH 1 , Rahman MFA 1 , Samsusah S 1 , De Silva JR 2 , Ng DC 3 , Ghozali AH 4 Show all authors , Tan JH 2 , Lai MY 2 , Amir A 2 , Liew JWK 2 , Lau YL 2

Affiliations 

  • 1 Lipis District Health Office, 27200 Kuala Lipis, Pahang, Malaysia
  • 2 Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
  • 3 Department of Pediatrics, Hospital Tuanku Ja'afar, 70300 Seremban, Negeri Sembilan, Malaysia
  • 4 Department of Pediatrics, Hospital Kuala Lipis, 27200 Kuala Lipis, Pahang, Malaysia
Trans R Soc Trop Med Hyg, 2020 Sep 01;114(9):700-703.
PMID: 32511702 DOI: 10.1093/trstmh/traa042

Abstract

Five children in Pos Lenjang, Pahang, Malaysia were PCR-positive for vivax malaria and were admitted to the hospital from 5 to 26 July 2019. One of the patients experienced three episodes of recurrence of vivax malaria. Microsatellite analysis showed that reinfection is unlikely. Drug resistance analysis indicated that Riamet (artemether-lumefantrine) is effective. Cytochrome P450 2D6 (CYP2D6) testing showed that this patient has defective CYP2D6 function. Primaquine failure to clear the Plasmodium vivax hypnozoites may be the cause of recurring infections in this patient. This report highlights the need for the development of liver-stage curative antimalarials that do not require metabolism by the CYP2D6 enzyme.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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