Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites

Mallika Imwong, Georges Snounou, Sasithon Pukrittayakamee, Naowarat Tanomsing, Ryong Kim Jung, Amitab Nandy, Jean Paul Guthmann, Francois Nosten, Jane Carlton, Sornchai Looareesuwan, Shalini Nair, Daniel Sudimack, Nicholas P J Day, Timothy J C Anderson, Nicholas J. White

Research output: Contribution to journalArticle

Abstract

Background. 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.

Original languageEnglish (US)
Pages (from-to)927-933
Number of pages7
JournalJournal of Infectious Diseases
Volume195
Issue number7
DOIs
StatePublished - Apr 1 2007

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Plasmodium vivax
Malaria
Recurrence
Myanmar
Vivax Malaria
Parasites
Parasitemia
Thailand
Infection
Population
India
Antimalarials
Genotype

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Imwong, M., Snounou, G., Pukrittayakamee, S., Tanomsing, N., Jung, R. K., Nandy, A., ... White, N. J. (2007). Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. Journal of Infectious Diseases, 195(7), 927-933. https://doi.org/10.1086/512241

Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. / Imwong, Mallika; Snounou, Georges; Pukrittayakamee, Sasithon; Tanomsing, Naowarat; Jung, Ryong Kim; Nandy, Amitab; Guthmann, Jean Paul; Nosten, Francois; Carlton, Jane; Looareesuwan, Sornchai; Nair, Shalini; Sudimack, Daniel; Day, Nicholas P J; Anderson, Timothy J C; White, Nicholas J.

In: Journal of Infectious Diseases, Vol. 195, No. 7, 01.04.2007, p. 927-933.

Research output: Contribution to journalArticle

Imwong, M, Snounou, G, Pukrittayakamee, S, Tanomsing, N, Jung, RK, Nandy, A, Guthmann, JP, Nosten, F, Carlton, J, Looareesuwan, S, Nair, S, Sudimack, D, Day, NPJ, Anderson, TJC & White, NJ 2007, 'Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites', Journal of Infectious Diseases, vol. 195, no. 7, pp. 927-933. https://doi.org/10.1086/512241
Imwong M, Snounou G, Pukrittayakamee S, Tanomsing N, Jung RK, Nandy A et al. Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. Journal of Infectious Diseases. 2007 Apr 1;195(7):927-933. https://doi.org/10.1086/512241
Imwong, Mallika ; Snounou, Georges ; Pukrittayakamee, Sasithon ; Tanomsing, Naowarat ; Jung, Ryong Kim ; Nandy, Amitab ; Guthmann, Jean Paul ; Nosten, Francois ; Carlton, Jane ; Looareesuwan, Sornchai ; Nair, Shalini ; Sudimack, Daniel ; Day, Nicholas P J ; Anderson, Timothy J C ; White, Nicholas J. / Relapses of Plasmodium vivax infection usually result from activation of heterologous hypnozoites. In: Journal of Infectious Diseases. 2007 ; Vol. 195, No. 7. pp. 927-933.
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abstract = "Background. 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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AU - Snounou, Georges

AU - Pukrittayakamee, Sasithon

AU - Tanomsing, Naowarat

AU - Jung, Ryong Kim

AU - Nandy, Amitab

AU - Guthmann, Jean Paul

AU - Nosten, Francois

AU - Carlton, Jane

AU - Looareesuwan, Sornchai

AU - Nair, Shalini

AU - Sudimack, Daniel

AU - Day, Nicholas P J

AU - Anderson, Timothy J C

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