AI Article Synopsis
- Ghana has shifted its first-line treatment for uncomplicated malaria from chloroquine to a combination of amodiaquine (AQ) and artesunate due to effectiveness.
- AQ can lead to serious side effects like agranulocytosis and hepatotoxicity, which are concerning with increased usage.
- In a study of 200 children in Northern Ghana, CYP2C8 variants were analyzed, revealing the CYP2C8*2 variant at a frequency of 0.1675 but not detecting CYP2C8*3 or CYP2C8*4, indicating potential metabolism issues for those with CYP2C8*2 and raising risks of adverse events.
Article Abstract
Recently, Ghana has changed the first-line treatment of uncomplicated malaria from chloroquine to amodiaquine (AQ) plus artesunate. AQ may cause adverse events such as agranulocytosis and hepatoxicity. The pro-drug AQ is transformed by cytochrome P450 CYP2C8 to the active metabolite N-desethylaminodiaquine. Several polymorphic variants of CYP2C8 are known, some with reduced activity. In 200 randomly selected children from Northern Ghana, we determined the allele frequencies of the CYP2C8 variants CYP2C8*1 (wild type), CYP2C8*2, CYP2C8*3, and CYP2C8*4. We did not detect CYP2C8*3 and CYP2C8*4, but CYP2C8*2 showed an allele frequency of 0.1675. AQ metabolism in patients with CYP2C8*2 may be impaired, and with an increase of AQ based treatment the risk of severe adverse events may mount.
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| http://dx.doi.org/10.1111/j.1365-3156.2005.01525.x | DOI Listing |
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