Kinetics of viremia and NS1 antigenemia are shaped by immune status and virus serotype in adults with dengue

Dengue is a major public health problem in tropical and subtropical countries. Exploring the relationships between virological features of infection with patient immune status and outcome may help to identify predictors of disease severity and enable rational therapeutic strategies. Clinical feature...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2011-09, Vol.5 (9), p.e1309-e1309
Main Authors: Tricou, Vianney, Minh, Nguyet Nguyen, Farrar, Jeremy, Tran, Hien Tinh, Simmons, Cameron P
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults
Antigens, Viral - blood
Antiviral Agents - administration & dosage
Biology
Chloroquine - administration & dosage
Clinical outcomes
Dengue
Dengue - immunology
Dengue - pathology
Dengue - virology
Dengue fever
Dengue Virus - classification
Dengue Virus - immunology
Dengue Virus - pathogenicity
Development and progression
Diagnosis
Enzyme-linked immunosorbent assay
Female
Funding
Humans
Hypotheses
Illnesses
Infections
Male
Medicine
Patients
Permeability
Plasma
Polymerase chain reaction
Public health
Risk factors
Serotyping
Tropical diseases
Vietnam
Viral Nonstructural Proteins - blood
Viremia
Viremia - immunology
Viremia - virology
Viruses
Young Adult
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Summary:Dengue is a major public health problem in tropical and subtropical countries. Exploring the relationships between virological features of infection with patient immune status and outcome may help to identify predictors of disease severity and enable rational therapeutic strategies. Clinical features, antibody responses and virological markers were characterized in Vietnamese adults participating in a randomised controlled treatment trial of chloroquine. Of the 248 patients with laboratory-confirmed dengue and defined serological and clinical classifications 29 (11.7%) had primary DF, 150 (60.5%) had secondary DF, 4 (1.6%) had primary DHF and 65 (26.2%) had secondary DHF. DENV-1 was the commonest serotype (57.3%), then DENV-2 (20.6%), DENV-3 (15.7%) and DENV-4 (2.8%). DHF was associated with secondary infection (Odds ratio = 3.13, 95% CI 1.04-12.75). DENV-1 infections resulted in significantly higher viremia levels than DENV-2 infections. Early viremia levels were higher in DENV-1 patients with DHF than with DF, even if the peak viremia level was often not observed because it occurred prior to enrolment. Peak viremias were significantly less often observed during secondary infections than primary for all disease severity grades (P = 0.001). The clearance of DENV viremia and NS1 antigenemia occurs earlier and faster in patients with secondary dengue (P
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0001309