Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria

Mayxay, Mayfong; Pukrittayakamee, Sasithon; Chotivanich, Kesinee; Looareesuwan, Sornchai; White, Nicholas J.

doi:10.1016/s0035-9203(01)90156-7

Cited by 175Malaria Research and ControlPhytochemical compounds biological activitiesHemoglobinopathies and Related Disorders

Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria

Mayxay, Mayfong, Pukrittayakamee, Sasithon, Chotivanich, Kesinee, Looareesuwan, Sornchai, White, Nicholas J.·2001·Transactions of the Royal Society of Tropical Medicine and Hygiene

DOI 10.1016/s0035-9203(01)90156-7

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Abstract

The potential for Plasmodium falciparum histidine-rich protein-2 (PfHRP-2) dipstick tests to predict antimalarial treatment failure was investigated in a prospective study in Thailand of 38 patients admitted with severe malaria and 54 hospitalized with uncomplicated P. falciparum infections. Of these, 40 had subsequent recrudescence of their infections. Overall, 89% of patients with severe malaria and 61% of patients with uncomplicated malaria had positive PfHRP-2 dipstick tests for > 2 weeks following the start of treatment. Persistence was correlated positively with admission parasite counts, PfHRP-2 intensity scores and disease severity. PfHRP-2 tests which remained positive for > 2 weeks and PfHRP-2 reactive intensity scores on admission, at day 7 and day 14 did not predict treatment failure independent of admission parasitaemia. Freezing and thawing the blood samples did not significantly affect PfHRP-2 results tested by the dipstick technique. The PfHRP-2 dipstick test provides a useful indicator of recent severe malaria, but does not predict the therapeutic response.

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An important weakness of RDT-HRP2 tests is the prolonged half-life of HRP-2 antigen, which can be identified in plasma several weeks after parasite clearance and therefore cannot distinguish current from recent infection.
“An important weakness of RDT-HRP2 tests is the prolonged half-life of the antigen. HRP-2 can be identified in plasma samples several weeks after parasite clearance, and therefore cannot be used to distinguish current from recent infection [23–25].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [23]
These shortcomings hinder the use of existing RDTs for managing malaria and for monitoring treatment efficacy.
“These shortcomings hinder the use of existing RDT for managing malaria, and also for monitoring treatment efficacy [23–25].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [23]

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Authors: Mayxay, M., Pukrittayakamee, S., Chotivanich, K., Looareesuwan, S., & White, N. J.
Affiliations: Mahidol University (TH)
ORCID: Mayxay, Mayfong
Pukrittayakamee, Sasithon
Chotivanich, Kesinee
White, Nicholas J.
Venue: Transactions of the Royal Society of Tropical Medicine and Hygiene
Publisher: Oxford University Press (OUP)
Published: 2001-03
Volume: 95
Issue: 2
Pages: 179-182
ISSN: 0035-9203 (ISSN-L)
DOI: 10.1016/s0035-9203(01)90156-7
OpenAlex: W2012795621
Cited by: 175
References: 28
Citations by year: 2026: 1 · 2025: 8 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 8 · 2017: 7 · 2016: 4 · 2015: 13 · 2014: 12 · 2013: 11 · 2012: 11
FWCI: 3.47
Type: journal article
Language: en
Open access: closed
Locations: Transactions of the Royal Society of Tropical Medicine and Hygiene (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phytochemical compounds biological activities
Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
Keywords: Plasmodium falciparum, HRP-2, treatment failure prediction, malaria recrudescence, severe malaria, uncomplicated falciparum malaria, parasitemia
MeSH terms: Histidine-Rich Glycoprotein, Adult, Antimalarials, Humans, Prospective Studies, Proteins, Reagent Kits, Diagnostic, Recurrence, Sensitivity and Specificity, Specimen Handling, Cryopreservation, Malaria, Falciparum, Treatment Failure

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Persistence of Plasmodium falciparum HRP-2 in successfully treated acute falciparum malaria

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