Liver involvement associated with dengue infection in adults in Vietnam.
Globally, the number of adults hospitalized with dengue has increased markedly in recent years. It has been suggested that hepatic dysfunction is more significant in this group than among children. We describe the spectrum and evolution of disease manifestations among 644 adults with dengue who were prospectively recruited on admission to a major infectious disease hospital in southern Vietnam and compare them with a group of patients with similar illnesses not caused by dengue. Transaminase levels increased in virtually all dengue patients and correlated with other markers of disease severity. However, peak enzyme values usually occurred later than other complications. Clinically severe liver involvement was infrequent and idiosyncratic, but usually resulted in severe bleeding. Chronic co-infection with hepatitis B was associated with modestly but significantly increased levels of alanine aminotransferase, but did not otherwise impact the clinical picture.
Trung
Dinh The
DT
Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. trungdt@oucru.org
Thao
Le Thi Thu
le TT
Hien
Tran Tinh
TT
Hung
Nguyen The
NT
Vinh
Nguyen Ngoc
NN
Hien
Pham Tran Dieu
PT
Chinh
Nguyen Tran
NT
Simmons
Cameron
C
Wills
Bridget
B
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003715:Dengue / Q000150:complications* / Q000453:epidemiology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D008107:Liver Diseases / Q000209:etiology* / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase