Abstract:
Oxidative agents can cause acute haemolytic anaemia in persons with G6PD deficiency. Understanding the relationship
between G6PD genotype and the phenotypic expression of the enzyme deficiency is necessary so that severe
haemolysis can be avoided. The patterns of oxidative haemolysis have been well described in G6PD deficient hemizygous
males and homozygous females; and haemolysis in the proportionally more numerous heterozygous females
has been documented mainly following consumption of fava beans and more recently dapsone. It has long been
known that 8-aminoquinolines, notably primaquine and tafenoquine, cause acute haemolysis in G6PD deficiency. To
support wider use of primaquine in Plasmodium vivax elimination, more data are needed on the haemolytic consequences
of 8-aminoquinolines in G6PD heterozygous females. Two recent studies (in 2017) have provided precisely
such data; and the need has emerged for the development of point of care quantitative testing of G6PD activity.
Another priority is exploring alternative 8-aminoquinoline dosing regimens that are practical and improve safety in
G6PD deficient individuals.
