High levels of plasma dengue viral load during defervescence in patients with dengue hemorrhagic fever: Implications for pathogenesis
Journal
Virology
Journal Volume
305
Journal Issue
2
Pages
330-338
Date Issued
2003
Author(s)
Wang W.-K.
Chao D.-Y.
Wu H.-C.
Liu Y.-C.
Li C.-M.
Lin S.-C.
Ho S.-T.
Huang J.-H.
King C.-C.
Abstract
Studies of the pathogenesis of dengue hemorrhagic fever (DHF), a potentially life-threatening disease, have revealed the importance of initial high levels of virus replication. However, the possible involvement of virus during the transition from fever to defervescence, a critical stage in determining the severity of disease, has not been appreciated. Using quantitative reverse transcription-polymerase chain reaction, we examined the levels of plasma dengue viral load during both fever and defervescence periods in patients from a DEN-3 outbreak in southern Taiwan in 1998. Higher levels of plasma dengue viral RNA were found in DHF patients than in DF patients. During defervescence, while the level of plasma dengue viral RNA was undetectable in most DF patients, it remains high in all DHF patients. Using a modified immunoprecipitation assay, we demonstrated for the first time that the plasma dengue viruses persisting during defervescence were in the immune complexes for most DHF patients. These findings suggest that continued active viral replication or delay in the clearance of viremia contributes to the pathogenesis of DHF. Moreover, high levels of plasma dengue viral RNA during defervescence may serve as a disease marker for DHF. ? 2003 Elsevier Science (USA).
SDGs
Other Subjects
virus RNA; adult; aged; antigen antibody complex; article; blood level; clinical article; dengue; Dengue virus; disease exacerbation; disease marker; epidemic; female; fever; human; immunoprecipitation; male; priority journal; quantitative assay; reverse transcription polymerase chain reaction; Taiwan; virus load; virus pathogenesis; virus replication; Dengue virus; Dengue virus group
Type
journal article