HRP2 gene deletion

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 false negative test results. In high parasitaemia the tests may still work in the presence of single gene deletions of HRP2 since the test also detects HRP3. (2) Deletions affecting both HRP2 and HRP3 genes are now recognised and these cause fully negative test results. 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. Return to HRP2 page