Primaquine for Plasmodium vivax radical cure: What we do not know and why it matters

Int J Parasitol Drugs Drug Resist. 2021 Apr;15:36-42. doi: 10.1016/j.ijpddr.2020.12.004. Epub 2021 Jan 24.

Abstract

Plasmodium vivax radical cure requires the administration of a blood schizonticide for killing blood-stage parasites and the addition of a drug able to kill hypnozoites, the dormant parasite stages residing in the liver of infected patients. All drugs used clinically for killing hypnozoites are 8-aminoquinolines and among them, primaquine has been at the forefront of P. vivax case management for decades. We discuss here the possible factors that could lead to the emergence and selection of P. vivax primaquine resistant parasites and emphasize on how a better understanding of the mechanisms underlying primaquine treatment and hypnozoite biology is needed to prevent this catastrophic scenario from happening.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Antimalarials* / pharmacology
  • Antimalarials* / therapeutic use
  • Humans
  • Liver
  • Malaria, Vivax* / drug therapy
  • Parasites*
  • Plasmodium vivax
  • Primaquine / therapeutic use

Substances

  • Antimalarials
  • Primaquine