Association of CYP2C19, CYP2D6 and CYP3A4 Genetic Variants on Primaquine Hemolysis in G6PD-Deficient Patients

In the Amazon, treatment for Plasmodium vivax is chloroquine plus primaquine. However, this regimen limited due to risk of acute hemolytic anemia in glucose-6-phosphate dehydrogenase deficiency. Primaquine a prodrug that requires conversion by CYP2D6 enzyme be effective against malaria. A series cases were performed at an infectious diseases reference hospital Western Brazilian Amazon. The STANDARD G6PD (SD Biosensor®) assay was used infer status and real-time PCR genotype G6PD, CYP2C19, CYP3A4. Eighteen patients included, which 55.6% had African A− variant (G202A/A376G), 11.1% A+ (A376G), 5.6% Mediterranean (C563T) 27.8% wild type. CYP3A4 genotyping showed no statistically significant differences frequency star alleles between groups deficient normal. Elevated levels liver kidney markers G6PDd observed gNM, gRM gUM CYP2C19 (p < 0.05). Furthermore, study there influence CYPs on hemolysis. These findings reinforce importance studies mapping deficiency genetic variations This will allow us validate prevalence determine their hemolysis with malaria, helping decide regimen.