HRP2 gene deletion: Difference between revisions
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|colspan="1" style = "font-size:100%; color:blasck; background: FFFAFA"|<span style="color:navy>'''Detection limits of RDTs'''</span> | |colspan="1" style = "font-size:100%; color:blasck; background: FFFAFA"|<span style="color:navy>'''Detection limits of RDTs'''</span> | ||
Gene-deletion mutations affecting ''HRP2'' and ''HRP3'' genes have been reported in South America, sub-Saharan Africa, and Asia, most likely though genetic selection of cases not detected by RDT testing. | <span style="font-size:90%">Gene-deletion mutations affecting ''HRP2'' and ''HRP3'' genes have been reported in South America, sub-Saharan Africa, and Asia, most likely though genetic selection of cases not detected by RDT testing.</span> | ||
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(1) Deletions of ''HRP2'' prevent its synthesis, causing reduced sensitivity (or sometimes entirely negative test results). In the presence of high parasitaemia HRP2 tests may still work even in the presence of single gene deletions of ''HRP2'' since the test also detects HRP3 protein. | <span style="font-size:90%">(1) Deletions of ''HRP2'' prevent its synthesis, causing reduced sensitivity (or sometimes entirely negative test results). In the presence of high parasitaemia HRP2 tests may still work even in the presence of single gene deletions of ''HRP2'' since the test also detects HRP3 protein.</span> | ||
(2) Note also the '''dual gene-deletions''' affecting both ''HRP2'' and ''HRP3'' genes are now recognised, and these cause fully negative test results. | <span style="font-size:90%">(2) Note also the '''dual gene-deletions''' affecting both ''HRP2'' and ''HRP3'' genes are now recognised, and these cause fully negative test results.</span> | ||
The use of HRP to detect malaria may not be appropriate where the ''HRP2'' deletion rate is 5% or greater. Tests that combine ''HRP2'' with another antibody (either aldolase or pLDH) may help overcome these problems. | <span style="font-size:90%">The use of HRP to detect malaria may not be appropriate where the ''HRP2'' deletion rate is 5% or greater. Tests that combine ''HRP2'' with another antibody (either aldolase or pLDH) may help overcome these problems.</span> | ||
Revision as of 15:55, 26 September 2024
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| Detection limits of RDTs
Gene-deletion mutations affecting HRP2 and HRP3 genes have been reported in South America, sub-Saharan Africa, and Asia, most likely though genetic selection of cases not detected by RDT testing. (1) Deletions of HRP2 prevent its synthesis, causing reduced sensitivity (or sometimes entirely negative test results). In the presence of high parasitaemia HRP2 tests may still work even in the presence of single gene deletions of HRP2 since the test also detects HRP3 protein. (2) Note also the dual gene-deletions affecting both HRP2 and HRP3 genes are now recognised, and these cause fully negative test results.
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