The perils of PCR: can we accurately 'correct' antimalarial trials?

被引:42
作者
Juliano, Jonathan J. [4 ]
Gadalla, Nahla [2 ,3 ]
Sutherland, Colin J. [2 ,3 ]
Meshnick, Steven R. [1 ]
机构
[1] Univ N Carolina, Dept Epidemiol, Gillings Sch Global Publ Hlth, Chapel Hill, NC 27599 USA
[2] Hosp Trop Dis, Dept Clin Parasitol, London WC1E 6JB, England
[3] Univ London London Sch Hyg & Trop Med, Dept Infect & Trop Dis, London WC1E 7HT, England
[4] Univ N Carolina, Sch Med, Dept Med, Div Infect Dis, Chapel Hill, NC 27599 USA
关键词
PLASMODIUM-FALCIPARUM MALARIA; HETERODUPLEX TRACKING ASSAY; POLYMERASE-CHAIN-REACTION; CLINICAL-TRIALS; ARTEMETHER-LUMEFANTRINE; POPULATION-DYNAMICS; INFECTIONS; PARASITES; EFFICACY; RECRUDESCENCE;
D O I
10.1016/j.pt.2009.12.007
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
During follow-up in antimalarial drug trials, treated subjects can be newly infected. PCR correction is used to distinguish this re-infection from drug failure (recrudescence) and to adjust final drug efficacy estimates. The epidemiological, biological and technical limitations of PCR correction and how this can lead to misclassification in drug trial outcomes are underappreciated. This article considers these limitations and proposes a framework for reporting, interpreting and improving PCR correction of antimalarial trials.
引用
收藏
页码:119 / 124
页数:6
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