Prevalence in Northern Angola of Cytochrome P450 (CYP) 2C8 Alleles Associated with Amodiaquine Decreased Metabolism

Am J Trop Med Hyg. 2025 Dec 4;114(2):302-304. doi: 10.4269/ajtmh.24-0710. Print 2026 Feb 4.

Abstract

Amodiaquine-artesunate is one of the recommended options by the Angolan National Malaria Control Program for the treatment of uncomplicated malaria and for malaria seasonal chemoprevention. CYP2C8 is a critical enzyme in the metabolism of amodiaquine. The CYP2C8 gene harbors alleles coding for less active enzymes that have been linked to amodiaquine-associated adverse events. In this work, we analyzed the prevalences of the CYP2C8 main alleles in a sample of the Angolan population. We found an expected robust frequency of a very-low-activity allele, CYP2C8*2 (18.2%) but also the unusual presence of alleles CYP2C8*3 (1%) and CYP2C8*4 (0.5%). Together, these alleles were seen in a non-negligible group of Plasmodium falciparum malaria patients and children under amodiaquine-based therapies and prophylactic strategies.

MeSH terms

  • Adolescent
  • Adult
  • Alleles
  • Amodiaquine* / metabolism
  • Amodiaquine* / therapeutic use
  • Angola / epidemiology
  • Antimalarials* / metabolism
  • Antimalarials* / therapeutic use
  • Child
  • Child, Preschool
  • Cytochrome P-450 CYP2C8* / genetics
  • Cytochrome P-450 CYP2C8* / metabolism
  • Female
  • Gene Frequency
  • Humans
  • Infant
  • Malaria, Falciparum* / drug therapy
  • Malaria, Falciparum* / epidemiology
  • Malaria, Falciparum* / genetics
  • Male
  • Prevalence

Substances

  • Amodiaquine
  • Antimalarials
  • Cytochrome P-450 CYP2C8
  • CYP2C8 protein, human