Biological resistance of hydroxychloroquine for Plasmodium vivax malaria in the Republic of Korea.
The Republic of Korea (ROK) Army instituted a vivax malaria chemoprophylaxis program (hydroxychloroquine [HCQ] 400 mg per week) in 1997 that was expanded to nearly 200,000 soldiers by 2007, raising concerns for the emergence of drug-resistant vivax malaria. Therefore, a study of whole blood HCQ concentrations for all malaria patients admitted to four ROK Army hospitals was conducted from June through September 2007. For all 142 vivax malaria patients enrolled, fevers returned to normal by Day 3 post-treatment and all thin blood films were negative for parasites by Day 7. Pre-treatment whole blood concentrations of HCQ for 14 patients were > 100 ng/mL. Eight of the patients were enrolled in the ROK Army chemoprophylaxis program that reported taking HCQ as directed, with the last pill taken > or = 4 days before diagnosis. Although there was no evidence of clinical resistance, chemoprophylaxis data indicates the biological resistance or tolerance to HCQ in ROK.
Lee
Sei Won
SW
Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea.
Lee
Minhee
M
Lee
Dae Dong
DD
Kim
Changsoo
C
Kim
Yeon-Joo
YJ
Kim
Jung-Yeon
JY
Green
Michael D
MD
Klein
Terry A
TA
Kim
Heung Chul
HC
Nettey
Henry
H
Ko
Dong Hoon
DH
Kim
Hyungsuk
H
Park
Inho
I
D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology*; D002738:Chloroquine / Q000494:pharmacology; D004351:Drug Resistance; D006801:Humans; D006886:Hydroxychloroquine / Q000494:pharmacology*; D007723:Korea / Q000453:epidemiology; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010966:Plasmodium vivax / Q000187:drug effects*; D011319:Primaquine / Q000494:pharmacology; D055815:Young Adult
D000962:Antimalarials; D006886:Hydroxychloroquine; D002738:Chloroquine; D011319:Primaquine