Tithi Pal1, Sudip K Dutta1, Syamsundar Mandal2, Bibhuti Saha3, Anusri Tripathi4. 1. Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata 700073, West Bengal, India. 2. Department of Epidemiology and Biostatistics, Chittaranjan National Cancer Research Institute, 37, S. P. Mukherjee Road, Kolkata 700026, West Bengal, India. 3. Department of Tropical Medicine, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata 700073, West Bengal, India. 4. Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata 700073, West Bengal, India. Electronic address: anusri.stm@gmail.com.
Abstract
BACKGROUND: During last three decades, dengue (DF), an arthropod-borne viral disease is increasingly prevalent worldwide including India, resulting in serious public health problems. OBJECTIVE: This study was carried out during 2012-2013 to evaluate the association of WHO-classified dengue disease symptoms with viral load (VL) and serum IFN-gamma levels in dengue patients from India. STUDY DESIGN: Blood samples were collected from dengue symptomatic febrile patients (n=127). DEN-VL was determined by quantitative real-time RT-PCR using RNA, extracted from plasma and anti-DENV-IgM was detected by ELISA. Serum IFN-gamma level was detected by ELISA among DENV infected and age-matched control individuals. Association between DEN-VL and IFN-gamma level in patient's sera with WHO-classified disease symptoms was statistically analyzed. RESULTS: DENV RNA and anti-DENV-IgM was detected among 94% (n=73) and 36% (n=28) of dengue infected patients (n=78) respectively. Fever, nausea, rash, aches & pains, leucopenia and persistent vomiting were significantly correlated with DENV infection (P-value<0.05). Only patients with high-VL exhibited leucopenia, persistent vomiting, abdominal pain and clinical fluid accumulation, which were warning signs of dengue infection according to revised WHO-criteria (P-value<0.05). Clinical symptoms of DENV infected patients, viz. leucopenia, abdominal pain and persistent vomiting were significantly correlated to each other (P-value<0.05). Increased serum IFN-gamma level was detected among dengue patients compared to control individuals. DEN-VL and symptoms like nausea, leucopenia, persistent vomiting and abdominal pain were significantly negatively correlated with serum IFN-gamma level (P-value<0.05). CONCLUSION: Serum IFN-gamma level and dengue viremia among acute stage patients might be used as early prognostic marker for disease severity prediction.
BACKGROUND: During last three decades, dengue (DF), an arthropod-borne viral disease is increasingly prevalent worldwide including India, resulting in serious public health problems. OBJECTIVE: This study was carried out during 2012-2013 to evaluate the association of WHO-classified dengue disease symptoms with viral load (VL) and serum IFN-gamma levels in dengue patients from India. STUDY DESIGN: Blood samples were collected from dengue symptomatic febrile patients (n=127). DEN-VL was determined by quantitative real-time RT-PCR using RNA, extracted from plasma and anti-DENV-IgM was detected by ELISA. Serum IFN-gamma level was detected by ELISA among DENV infected and age-matched control individuals. Association between DEN-VL and IFN-gamma level in patient's sera with WHO-classified disease symptoms was statistically analyzed. RESULTS: DENV RNA and anti-DENV-IgM was detected among 94% (n=73) and 36% (n=28) of dengue infectedpatients (n=78) respectively. Fever, nausea, rash, aches & pains, leucopenia and persistent vomiting were significantly correlated with DENV infection (P-value<0.05). Only patients with high-VL exhibited leucopenia, persistent vomiting, abdominal pain and clinical fluid accumulation, which were warning signs of dengue infection according to revised WHO-criteria (P-value<0.05). Clinical symptoms of DENV infectedpatients, viz. leucopenia, abdominal pain and persistent vomiting were significantly correlated to each other (P-value<0.05). Increased serum IFN-gamma level was detected among dengue patients compared to control individuals. DEN-VL and symptoms like nausea, leucopenia, persistent vomiting and abdominal pain were significantly negatively correlated with serum IFN-gamma level (P-value<0.05). CONCLUSION: Serum IFN-gamma level and dengue viremia among acute stage patients might be used as early prognostic marker for disease severity prediction.
Authors: Dominic Paquin-Proulx; Vivian I Avelino-Silva; Bianca A N Santos; Nathália Silveira Barsotti; Fabiana Siroma; Jessica Fernandes Ramos; Adriana Coracini Tonacio; Alice Song; Alvino Maestri; Natalia Barros Cerqueira; Alvina Clara Felix; José Eduardo Levi; Benjamin C Greenspun; Miguel de Mulder Rougvie; Michael G Rosenberg; Douglas F Nixon; Esper G Kallas Journal: PLoS Negl Trop Dis Date: 2018-01-22