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Journal of Clinical Microbiology, September 2004, p. 4237-4241, Vol. 42, No. 9
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.9.4237-4241.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Persistent Histidine-Rich Protein 2, Parasite Lactate Dehydrogenase, and Panmalarial Antigen Reactivity after Clearance of Plasmodium falciparum Monoinfection

Jamshaid Iqbal,1* Ahmed Siddique,2 Mohammad Jameel,2 and Persotum R. Hira1

Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait,1 District Health Center, Punjab, Pakistan2

Received 14 February 2004/ Returned for modification 21 April 2004/ Accepted 31 May 2004

We tested 240 patients with Plasmodium falciparum monoinfection for persistent parasite antigenemia after successful standardized antimalarial therapy by using the ICT Malaria Pf/Pv and OptiMAL-IT assays that detect the malaria antigens Plasmodium falciparum histidine-rich protein 2 (HRP2) and parasite lactate dehydrogenase (pLDH), respectively, as well as a panmalarial antigen (PMA). The patients were screened for antigenemia on days 0, 3, 7, and 14 of follow-up. On day 0, all 240 patients showed positive reactivity with both assays. Of the 229 cases with negative parasitemia on day 3, persistent antigenemia was observed in 207 (90.4%) of the cases: 188 (82.1%) for HRP2 antigen and 75 (32.8%) for PMA. There was a gradual decrease in antigenemia on follow-up to day 14; however, the drop in reactivity to PMA was less than that for HRP2 antigen. In contrast to HRP2 antigenemia, there was a significant decrease in pLDH antigenemia to 38.4% and to 14.8% (PMA) on day 3 (P < 0.03). The pLDH antigenemia level dropped further to 14.8% on day 7. There was no significant association of persistent antigenemia with gametocytemia. One case with gametocytemia was negative for both the antigens. In conclusion, the OptiMAL-IT assay is more sensitive than the ICT Malaria Pf/Pv test for monitoring therapeutic responses after antimalarial therapy since the LDH activity ceases when the malarial parasite dies.

* Corresponding author. Mailing address: Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait. Phone: 965-5312300. Fax: 965-5332719. E-mail: iqbal{at}hsc.kuniv.edu.kw.

Journal of Clinical Microbiology, September 2004, p. 4237-4241, Vol. 42, No. 9
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.9.4237-4241.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Murray, C. K., Gasser, R. A. Jr., Magill, A. J., Miller, R. S. (2008). Update on Rapid Diagnostic Testing for Malaria. Clin. Microbiol. Rev. 21: 97-110 [Abstract] [Full Text]  
  • GENRICH, G. L., GUARNER, J., PADDOCK, C. D., SHIEH, W.-J., GREER, P. W., BARNWELL, J. W., ZAKI, S. R. (2007). FATAL MALARIA INFECTION IN TRAVELERS: NOVEL IMMUNOHISTOCHEMICAL ASSAYS FOR THE DETECTION OF PLASMODIUM FALCIPARUM IN TISSUES AND IMPLICATIONS FOR PATHOGENESIS. Am J Trop Med Hyg 76: 251-259 [Abstract] [Full Text]  


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