title: Incidence and predictive factors of transaminase elevation in patients consulting for dengue fever in Cayenne Hospital, French Guiana.
abstract: BACKGROUND
  The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors.
  
  
  METHODS
  In 2013, a longitudinal study was performed using data from all cases of dengue seen in Cayenne Hospital. Cox proportional modeling was used. Signs of major transaminase elevation were defined as an increase in aspartate amino transferase (AST) or alanine amino transferase (ALT) concentration over 10 times the normal value (10N).
  
  
  RESULTS
  There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of transaminase elevation (10N) was 0.55 per 100 person-days. Six patients had major transaminase elevation with AST>1000 units (0.43 per 1000 patient-days), and 73 patients (4.6%) developed transaminase elevation with AST >10N. The variables independently associated with major transaminase elevation were hyponatremia, low platelets, dehydration, hematocrit increase, food intolerance, positive nonstructural protein 1 (NS1), age over 15 years and the notion of paracetamol intake.
  
  
  CONCLUSIONS
  Although very frequent, the incidence of major transaminase elevation was lower than reported elsewhere perhaps because of good access to care, or of the particular serotype causing this epidemic. The patients with transaminase elevation tended to be older, more severe and taking paracetamol. .
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana.
authors.forename: Félix
authors.initials: F
authors.lastname: Djossou
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Vesin
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Gaelle
authors.initials: G
authors.lastname: Walter
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana.
authors.forename: Loïc
authors.initials: L
authors.lastname: Epelboin
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana Departement des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Emilie
authors.initials: E
authors.lastname: Mosnier
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Bastien
authors.initials: B
authors.lastname: Bidaud
authors.affiliation: Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana.
authors.forename: Philippe
authors.initials: P
authors.lastname: Abboud
authors.affiliation: Laboratoire Polyvalent, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Antoine
authors.initials: A
authors.lastname: Okandze
authors.affiliation: Laboratoire de virologie, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana.
authors.forename: Severine
authors.initials: S
authors.lastname: Mattheus
authors.affiliation: Department of Pediatrics, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Narcisse
authors.initials: N
authors.lastname: Elenga
authors.affiliation: Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana Laboratory of Parasitology and Mycology, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
authors.forename: Magalie
authors.initials: M
authors.lastname: Demar
authors.affiliation: Unité des Maladies Tropicales et du Voyageur, Centre Hospitalier Universitaire de Bordeaux, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Malvy
authors.affiliation: Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana Centre d'Investigation Clinique Antilles Guyane, INSERM 1424, Centre Hospitalier de Cayenne, French Guiana mathieu.nacher66@gmail.com mathieu.nacher@ch-cayenne.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003715:Dengue / Q000201:enzymology* / Q000453:epidemiology / Q000821:virology; D058872:Epidemics; D005260:Female; D005500:Follow-Up Studies; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Dengue; Paracetamol; Predictors; Transaminase elevation