The impact of phenotypic and genotypic G6PD deficiency on risk of Plasmodium vivax infection

Research published this week in PLoS Medicine by Toby Leslie and colleagues shows that the Mediterranean G6PD variant protects against P. vivax infection in a cohort of Afghan refugees. Although further studies are needed to determine whether other G6PD variants protect against P. vivax malaria, these findings suggest that P. vivax malaria might be responsible for the retention of the G6PD deficiency trait in some human populations.

These findings may have implications for the treatment of P. vivax malaria. Currently, in most places where P. vivax malaria is common, primaquine is not routinely prescribed because this drug can trigger hemolytic anemia in G6PD-deficient people. These new findings suggest that the risk of exposure to primaquine among people infected with P. vivax might be lower than previously assumed because G6PD deficiency is less common among P. vivax-infected patients than among the general population. But routine use of primaquine for P. vivax malaria will only become possible when a simple test for G6PD deficiency (currently unavailable) is developed.

More information:
Leslie T, Briceno M, Mayan I, Mohammed N, Klinkenberg E, et al. (2010) The Impact of Phenotypic and Genotypic G6PD Deficiency on Risk of Plasmodium vivax Infection: A Case-Control Study amongst Afghan Refugees in Pakistan. PLoS Med 7(5): e1000283. doi:10.1371/journal.pmed.1000283

Provided by Public Library of Science