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. 2019 Jun 10;12(1):293.
doi: 10.1186/s13071-019-3549-x.

Clearance dynamics of lactate dehydrogenase and aldolase following antimalarial treatment for Plasmodium falciparum infection

Mateusz M Plucinski  1   2 , Peter D McElroy  3   4 , Pedro Rafael Dimbu  5 , Filomeno Fortes  5 , Doug Nace  3 , Eric S Halsey  3   4 , Eric Rogier  3
Affiliations

Clearance dynamics of lactate dehydrogenase and aldolase following antimalarial treatment for Plasmodium falciparum infection

Mateusz M Plucinski et al. Parasit Vectors. .

Abstract

Background: Lingering post-treatment parasite antigen in blood complicates malaria diagnosis through antigen detection. Characterization of antigen clearance dynamics is important for interpretation of positive antigen detection tests.

Results: We used a bead-based serological assay to measure lactate dehydrogenase (LDH), aldolase (Aldo), and histidine-rich protein 2 (HRP2) levels in 196 children with Plasmodium falciparum malaria treated with effective antimalarials and followed for 28 to 42 days as part of therapeutic efficacy studies in Angola. Compared to pre-treatment levels, antigen concentrations two days after treatment declined by 99.7% for LDH, 96.3% for Aldo, and 54.6% for HRP2. After Day 2, assuming a first-order kinetics clearance model, half-lives of the antigens were 1.8 days (95% CI: 1.5-2.3) for LDH, 3.2 days (95% CI: 3.0-3.4) for Aldo, and 4.8 days (95% CI: 4.7-4.9) for HRP2.

Conclusions: LDH and Aldo show substantially different clearance rates than HRP2, and their presence is largely indicative of active infection.

Keywords: Antigen; HRP2; Malaria; Rapid diagnostic test.

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Conflict of interest statement

The authors declare they do not have any commercial or other associations that might pose a competing interests.

Figures

Fig. 1
Fig. 1
Decline in absolute malaria antigen following antimalarial treatment in Angolan children with uncomplicated P. falciparum infection. Dashed red line represents the limit of detection for each antigen
Fig. 2
Fig. 2
Persistence of malaria antigens following antimalarial treatment in Angolan children with uncomplicated P. falciparum infection. Dashed lines represent confidence intervals of the survival function
See this image and copyright information in PMC

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