title: Effects of mefloquine use on Plasmodium vivax multidrug resistance.
abstract: Numerous studies have indicated a strong association between amplification of the multidrug resistance-1 gene and in vivo and in vitro mefloquine resistance of Plasmodium falciparum. Although falciparum infection usually is not treated with mefloquine, incorrect diagnosis, high frequency of undetected mixed infections, or relapses of P. vivax infection triggered by P. falciparum infections expose non-P. falciparum parasites to mefloquine. To assess the consequences of such unintentional treatments on P. vivax, we studied variations in number of Pvmdr-1 (PlasmoDB accession no. PVX_080100, NCBI reference sequence NC_009915.1) copies worldwide in 607 samples collected in areas with different histories of mefloquine use from residents and from travelers returning to France. Number of Pvmdr-1 copies correlated with drug use history. Treatment against P. falciparum exerts substantial collateral pressure against sympatric P. vivax, jeopardizing future use of mefloquine against P. vivax. A drug policy is needed that takes into consideration all co-endemic species of malaria parasites.
authors.forename: Nimol
authors.initials: N
authors.lastname: Khim
authors.forename: Voahangy
authors.initials: V
authors.lastname: Andrianaranjaka
authors.forename: Jean
authors.initials: J
authors.lastname: Popovici
authors.forename: Saorin
authors.initials: S
authors.lastname: Kim
authors.forename: Arsene
authors.initials: A
authors.lastname: Ratsimbasoa
authors.forename: Christophe
authors.initials: C
authors.lastname: Benedet
authors.forename: Celine
authors.initials: C
authors.lastname: Barnadas
authors.forename: Remy
authors.initials: R
authors.lastname: Durand
authors.forename: Marc
authors.initials: M
authors.lastname: Thellier
authors.forename: Eric
authors.initials: E
authors.lastname: Legrand
authors.forename: Lise
authors.initials: L
authors.lastname: Musset
authors.forename: Michela
authors.initials: M
authors.lastname: Menegon
authors.forename: Carlo
authors.initials: C
authors.lastname: Severini
authors.forename: Bakri Y M
authors.initials: BY
authors.lastname: Nour
authors.forename: Magali
authors.initials: M
authors.lastname: Tichit
authors.forename: Christiane
authors.initials: C
authors.lastname: Bouchier
authors.forename: Odile
authors.initials: O
authors.lastname: Mercereau-Puijalon
authors.forename: Didier
authors.initials: D
authors.lastname: Ménard
mesh_terms: D002160:Cambodia / Q000453:epidemiology; D004351:Drug Resistance / Q000187:drug effects*; D005616:French Guiana / Q000453:epidemiology; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D008270:Madagascar / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology; D016780:Malaria, Vivax / Q000453:epidemiology / Q000469:parasitology*; D015767:Mefloquine / Q000627:therapeutic use*; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics / Q000378:metabolism*; D010963:Plasmodium falciparum / Q000187:drug effects; D010966:Plasmodium vivax / Q000187:drug effects*; D015800:Protozoan Proteins / Q000235:genetics / Q000378:metabolism*; D013397:Sudan / Q000453:epidemiology
chemical_list: D015767:Mefloquine; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D015800:Protozoan Proteins; C541684:Mdr1 protein, Plasmodium vivax