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What happens when Plasmodium parasites enter the liver?

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When Plasmodium parasites enter the liver via the bloodstream, the following process occurs:

  • Maturation: The sporozoites invade liver parenchyma cells and mature into forms known as schizonts.12
  • Multiplication: Over the course of one to two weeks, each schizont multiplies into thousands of new forms called merozoites.2
  • Release: Once mature, the merozoites break out of the liver cells and reenter the bloodstream to infect red blood cells.12

In the case of P. vivax and P. ovale, some sporozoites may remain in the liver in a dormant stage known as a "hypnozoite." These can persist for months or years before emerging to cause a relapse of the disease.2