Antifolates can have a role in the treatment of Plasmodium vivax

• Published in: Trends in parasitology Vol. 23; no. 5; pp. 213 - 222
• Main Authors: Hawkins, Vivian N, Joshi, Hema, Rungsihirunrat, Kanchana, Na-Bangchang, Kesara, Sibley, Carol Hopkins
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-05-2007; Elsevier
• Subjects: Animals; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimalarials - therapeutic use; Antiparasitic agents; Biological and medical sciences; Dihydropteroate Synthase - genetics; Drug Combinations; Drug Resistance; Folic Acid Antagonists - therapeutic use; Gastroenterology and Hepatology; Genotype; Humans; Infectious Disease; Malaria, Vivax - drug therapy; Medical sciences; Mutation; Pharmacology. Drug treatments; Plasmodium vivax; Plasmodium vivax - drug effects; Plasmodium vivax - enzymology; Pyrimethamine - therapeutic use; Sulfadoxine - therapeutic use; Tetrahydrofolate Dehydrogenase - genetics; Treatment Outcome; Parasite; Protozoa; Plasmodium vivax; Apicomplexa
• ISSN: 1471-4922; 1471-5007
• DOI: 10.1016/j.pt.2007.03.002

Plasmodium vivax is a serious health concern in many regions and is sometimes inadvertently treated with sulfadoxine–pyrimethamine (SP). Mutations in the genes that encode dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) confer resistance to pyrimethamine and sulfadoxine, respectively. Numerous studies have examined the prevalence and diversity of mutations in P. vivax dhfr and some have assessed the relationship between dhfr genotype and clinical or in vitro response to pyrimethamine. Other studies have examined the impact of dhps genotype on response to sulfadoxine. These data indicate that, under certain circumstances, SP could be a valuable tool in the fight against P. vivax.