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Immunological and viral determinants of dengue severity in hospitalized adults in Ha Noi, Viet Nam

PLoS neglected tropical diseases, 2011-03, Vol.5 (3), p.e967-e967 [Peer Reviewed Journal]

2011 Fox et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Fox A, Hoa LNM, Simmons CP, Wolbers M, Wertheim HFL, et al. (2011) Immunological and Viral Determinants of Dengue Severity in Hospitalized Adults in Ha Noi, Viet Nam. PLoS Negl Trop Dis 5(3): e967. doi:10.1371/journal.pntd.0000967 ;Fox et al. 2011 ;ISSN: 1935-2735 ;ISSN: 1935-2727 ;EISSN: 1935-2735 ;DOI: 10.1371/journal.pntd.0000967 ;PMID: 21390156

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Title:
Immunological and viral determinants of dengue severity in hospitalized adults in Ha Noi, Viet Nam
Author: Fox, Annette ; Le, Nguyen Minh Hoa ; Simmons, Cameron P ; Wolbers, Marcel ; Wertheim, Heiman F L ; Pham, Thi Khuong ; Tran, Thi Hai Ninh ; Trinh, Thi Minh Lien ; Nguyen, Thi Lien ; Nguyen, Vu Trung ; Nguyen, Duc Hien ; Farrar, Jeremy ; Horby, Peter ; Taylor, Walter R ; Nguyen, Van Kinh
Rico-Hesse, Rebeca
Subjects: Adult ; Adults ; Cluster Analysis ; Cross-Sectional Studies ; Dengue - classification ; Dengue - immunology ; Dengue - pathology ; Dengue - virology ; Dengue fever ; Dengue Virus - genetics ; Dengue Virus - immunology ; Dengue Virus - pathogenicity ; Epidemics ; Female ; Genotype ; Health care ; Hospitalization ; Hospitals ; Humans ; Illnesses ; Immunology ; Immunology/Cellular Microbiology and Pathogenesis ; Immunology/Immunity to Infections ; Infections ; Infectious Diseases ; Infectious Diseases/Neglected Tropical Diseases ; Infectious Diseases/Viral Infections ; Male ; Molecular Sequence Data ; Patients ; Plasma ; Public health ; RNA, Viral - blood ; RNA, Viral - genetics ; Sequence Analysis, DNA ; Serology ; Serotyping ; Severity of Illness Index ; Tropical diseases ; Vietnam ; Viral Load ; Virology ; Virology/Mechanisms of Resistance and Susceptibility, including Host Genetics
Is Part Of: PLoS neglected tropical diseases, 2011-03, Vol.5 (3), p.e967-e967
Description: The relationships between the infecting dengue serotype, primary and secondary infection, viremia and dengue severity remain unclear. This cross-sectional study examined these interactions in adult patients hospitalized with dengue in Ha Noi. 158 patients were enrolled between September 16 and November 11, 2008. Quantitative RT-PCR, serology and NS1 detection were used to confirm dengue infection, determine the serotype and plasma viral RNA concentration, and categorize infections as primary or secondary. 130 (82%) were laboratory confirmed. Serology was consistent with primary and secondary infection in 34% and 61%, respectively. The infecting serotype was DENV-1 in 42 (32%), DENV-2 in 39 (30%) and unknown in 49 (38%). Secondary infection was more common in DENV-2 infections (79%) compared to DENV-1 (36%, p<0.001). The proportion that developed dengue haemorrhagic fever (DHF) was 32% for secondary infection compared to 18% for primary infection (p = 0.14), and 26% for DENV-1 compared to 28% for DENV-2. The time until NS1 and plasma viral RNA were undetectable was shorter for DENV-2 compared to DENV-1 (p≤0.001) and plasma viral RNA concentration on day 5 was higher for DENV-1 (p = 0.03). Plasma viral RNA concentration was higher in secondary infection on day 5 of illness (p = 0.046). We didn't find an association between plasma viral RNA concentration and clinical severity. Dengue is emerging as a major public health problem in Ha Noi. DENV-1 and DENV-2 were the prevalent serotypes with similar numbers and clinical presentation. Secondary infection may be more common amongst DENV-2 than DENV-1 infections because DENV-2 infections resulted in lower plasma viral RNA concentrations and viral RNA concentrations were higher in secondary infection. The drivers of dengue emergence in northern Viet Nam need to be elucidated and public health measures instituted.
Publisher: United States: Public Library of Science
Language: English
Identifier: ISSN: 1935-2735
ISSN: 1935-2727
EISSN: 1935-2735
DOI: 10.1371/journal.pntd.0000967
PMID: 21390156
Source: GFMER Free Medical Journals
MEDLINE
PubMed Central
Public Library of Science (PLoS)
ProQuest Central
DOAJ Directory of Open Access Journals

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Immunological and viral determinants of dengue severity in hospitalized adults in Ha Noi, Viet Nam

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