Prevalence of antifolate drug resistance markers in Plasmodium vivax in China.
10.1007/s11684-021-0894-x
- Author:
Fang HUANG
1
;
Yanwen CUI
2
;
He YAN
2
;
Hui LIU
3
;
Xiangrui GUO
4
;
Guangze WANG
5
;
Shuisen ZHOU
2
;
Zhigui XIA
2
Author Information
1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention), Shanghai, 200025, China. huangfang@nipd.chinacdc.cn.
2. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Center for Tropical Diseases, National Centre for International Research on Tropical Diseases, NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention), Shanghai, 200025, China.
3. Yunnan Institute of Parasitic Diseases, Puer, 665000, China.
4. Yingjiang County for Disease Control and Prevention, Yingjiang, 679300, China.
5. Hainan Center for Disease Control & Prevention, Haikou, 570203, China.
- Publication Type:Journal Article
- Keywords:
China;
Plasmodium vivax;
antifolates;
drug resistance;
molecular markers
- MeSH:
Antimalarials/pharmacology*;
China/epidemiology*;
Drug Combinations;
Drug Resistance/genetics*;
Folic Acid Antagonists/pharmacology*;
Humans;
Mutation;
Plasmodium vivax/genetics*;
Prevalence
- From:
Frontiers of Medicine
2022;16(1):83-92
- CountryChina
- Language:English
-
Abstract:
The dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) genes of Plasmodium vivax, as antifolate resistance-associated genes were used for drug resistance surveillance. A total of 375 P. vivax isolates collected from different geographical locations in China in 2009-2019 were used to sequence Pvdhfr and Pvdhps. The majority of the isolates harbored a mutant type allele for Pvdhfr (94.5%) and Pvdhps (68.2%). The most predominant point mutations were S117T/N (77.7%) in Pvdhfr and A383G (66.8%) in Pvdhps. Amino acid changes were identified at nine residues in Pvdhfr. A quadruple-mutant haplotype at 57, 58, 61, and 117 was the most frequent (57.4%) among 16 distinct Pvdhfr haplotypes. Mutations in Pvdhps were detected at six codons, and the double-mutant A383G/A553G was the most prevalent (39.3%). Pvdhfr exhibited a higher mutation prevalence and greater diversity than Pvdhps in China. Most isolates from Yunnan carried multiple mutant haplotypes, while the majority of samples from temperate regions and Hainan Island harbored the wild type or single mutant type. This study indicated that the antifolate resistance levels of P. vivax parasites were different across China and molecular markers could be used to rapidly monitor drug resistance. Results provided evidence for updating national drug policy and treatment guidelines.
