Influence of hemoglobin E trait on the antimalarial effect of artemisinin derivatives.
To determine whether hemoglobin E trait influences the antimalarial effect of artemisinin derivatives, we retrospectively compared 32 case patients with hemoglobin E trait to 32 control patients who did not have hemoglobin E, beta-thalassemia, glucose-6-phosphate dehydrogenase deficiency, or alpha-thalassemia trait on the basis of a mean corpuscular volume > or =78 femtoliters. All patients were admitted to the Hospital for Tropical Diseases in Bangkok, Thailand, with acute falciparum malaria. Control patients were matched to case patients with hemoglobin E trait by treatment with artemisinin derivatives versus other antimalarial drugs, by ethnic group, and by parasite count. Among 38 patients treated with artemisinin derivatives, the presence of hemoglobin E trait was associated with significantly faster parasite clearance (2.9-fold; 95% confidence interval [CI], 1.4-6.3; P=.006). Among 26 patients treated only with other antimalarial drugs, hemoglobin E trait did not significantly enhance parasite clearance (hazards ratio, 1.1; 95% CI, 0.5-2.5; P=. 8). Hemoglobin E trait may potentiate the antimalarial effect of artemisinin derivatives.
Hutagalung
R
R
Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Wilairatana
P
P
Looareesuwan
S
S
Brittenham
G M
GM
Gordeuk
V R
VR
D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins; D016022:Case-Control Studies; D005260:Female; D006446:Hemoglobin E / Q000235:genetics*; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D012189:Retrospective Studies; D012717:Sesquiterpenes / Q000627:therapeutic use*
D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D006446:Hemoglobin E; C031327:artemisinin