Co-occurrence of pfkelch13 and pfmdr1 variants in a recurrent Plasmodium falciparum infection following standard artemether-lumefantrine treatment - Takeaways - MDSpire
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Concurrent Presence of pfkelch13 and pfmdr1 Mutations in Recurring Plasmodium falciparum Infection After Standard Artemether-Lumefantrine Therapy

  • By

  • Joana Laranjinha

  • Andréa Luciana S. da Silva

  • Sara B. Lopes

  • Raquel Azevedo

  • Inês Lopes

  • Ana M. Costa

  • Ana Paula Arez

  • Ana Cláudia Carvalho

  • Pedro Vitor Cravo

  • Márcia M. Medeiros

  • September 18, 2026

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  • 1

    Certain variants in the gene encoding the KELCH13 protein are validated markers of partial artemisinin resistance. Variants or increased copy number of pfmdr1 are suggested markers of reduced response to lumefantrine.

  • 2

    A 50-year-old man developed recurrent Plasmodium falciparum infection after standard artemether-lumefantrine (ART-LUM) treatment. Analysis identified variants in pfk13 and pfmdr1.

  • 3

    The patient had obesity, type 2 diabetes, hypertension, and hepatic steatosis. Metabolic comorbidities may influence ART-LUM exposure, but their contribution to recurrence was not established.

  • 4

    Sequencing identified PfK13 T348I and PfMDR1 T199S variants, along with pfmdr1 N86 and Y184 alleles. No increased pfmdr1 copy number was detected.

  • 5

    The effects of PfK13 T348I and PfMDR1 T199S on ART-LUM susceptibility remain uncertain and require further in vitro investigation.

Original Source(s)

Co-occurrence of pfkelch13 and pfmdr1 variants in a recurrent Plasmodium falciparum infection following standard artemether-lumefantrine treatment

  • by Joana Laranjinha, Andréa Luciana S. da Silva, Sara B. Lopes, Raquel Azevedo, Inês Lopes, Ana M. Costa, Ana Paula Arez, Ana Cláudia Carvalho, Pedro Vitor Cravo, Márcia M. Medeiros

  • September 18, 2026

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