Acta Tropica 163 (2016) 1–6 Contents lists available at ScienceDirect Acta Tropica journal homepage: www.elsevier.com/locate/actatropica Changes in serum lipid profile in the acute and convalescent Plasmodium vivax malaria: A cohort study Teresinha C. Mesquita a , Thamires G.O. Martin a , Eduardo R. Alves Jr. b , Marcia B.C. Mello a , Andreia F. Nery a,c , Luciano T. Gomes a , Cor Jesus F. Fontes a,∗ a Hospital Universitário Júlio Müller, Universidade Federal de Mato Grosso, Rua Dr. Luiz Philipe Pereira Leite sn, Bairro Alvorada, Cuiabá (MT), CEP: 78048-902, Brazil b Centro Universitário UNIVAG, Curso de Biomedicina, Av Dom Orlando Chaves 2655, Bairro Cristo Rei, Várzea Grande (MT), CEP: 78118-000, Brazil c Faculdade de Ciências Biomédicas de Cacoal, Av. Cuiabá 3087, Bairro Jd Clodoaldo, Cacoal (RO), CEP: 76.963-665, Brazil a r t i c l e i n f o Article history: Received 29 April 2015 Received in revised form 15 July 2016 Accepted 16 July 2016 Available online 25 July 2016 Keywords: Malaria Plasmodium vivax Lipids a b s t r a c t Although serum lipids are known to be altered in Plasmodium falciparum-induced malaria, little is known about such changes due to Plasmodium vivax infection. This cohort study assessed serum concentrations of triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) in 164 patients in the acute phase of malaria caused by P. vivax and characterized these changes in the convalescent phase after treatment with chloroquine and primaquine. Compared to reference values, serum total cholesterol, LDL, and HDL levels were lower and triglyceride levels were higher in the acute phase. Moreover, the parasite density was negatively correlated with LDL (r = −0,189; p = 0.027) and HDL (r = −0,256; p = 0.001) serum levels. Eighty patients returned for clinical and laboratory revaluation 7–12 days after treatment initiation. All patients showed parasite clearance and the absence of symp- toms during the convalescent phase. Analysis of the serum lipids of these 80 patients showed significant increases in the serum levels of total cholesterol (p < 0.0001), LDL (p < 0.0001), and HDL (p < 0.0001) as well as a significant reduction in triglycerides (p = 0.004), indicating a trend towards a return to normal levels. This transient change in lipid profile between the acute and convalescent stages may be useful for the clinical monitoring of patients treated for vivax malaria. © 2016 Elsevier B.V. All rights reserved. 1. Introduction In 2013, almost 180,000 cases of malaria were reported in Brazil, 99.7% of which occurred in the Amazon region. Most of these cases (85.7%) were caused by Plasmodium vivax. Although P. vivax-induced malaria is generally a benign disease, it is increas- ingly being associated with severe evolution and fatal outcomes (Rogerson and Carter, 2008; Singh et al., 2011). Fever is still the most frequent symptom in malaria, followed by headache, chills, myal- gia, diarrhea, and intense weakness. More severe complications, which commonly occur in Plasmodium falciparum infection, include profound anemia, hypoglycemia, hypotension, severe hemolysis, metabolic acidosis, acute renal failure, acute pulmonary edema, and coma (WHO, 2000). All of these complications have been reported in P. vivax infection albeit less frequently (Rahimi et al., 2014). ∗ Corresponding author at: Julio Müller Universtity Hospital, Federal University of Mato Grosso, Rua Dr. Luiz Philipe P Leite Sn, Cuiaba, MT, CEP 78048-902, Brazil. E-mail address: corfontes@gmail.com (C.J.F. Fontes). The inflammatory phase of various pathological conditions such as acute infections (Luthold et al., 2007), traumas (Akgün et al., 1998), burns (Coombes et al., 1980) and myocardial ischemia (Kittl et al., 1992) involves transient and moderate changes in serum lipid concentrations. Despite the extensive evidence indi- cating serum lipids are altered in P. falciparum malaria (Baptista et al., 1996; Al-Omar et al., 2010; Jacob, 2014), similar informa- tion about P. vivax malaria from clinical practice is scarce (Krishna and Chandrika, 2009). In addition, few studies have evaluated the behaviors of these lipid changes after antimalarial treatment (Kim et al., 2008). Hypothesizing that lipid changes were also present in vivax malaria, we designed this study to analyze the serum lipid concentrations in the acute phase of patients presenting with acute forms of P. vivax-induced malaria and characterized changes in the convalescent phase after specific antimalarial treatment. http://dx.doi.org/10.1016/j.actatropica.2016.07.010 0001-706X/© 2016 Elsevier B.V. All rights reserved.