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Slower rates of clearance of viral load and virus-containing immune complexes in patients with dengue hemorrhagic fever.
Clin Infect Dis. 2006 Oct 15; 43(8):1023-30.CI

Abstract

BACKGROUND

Although previous studies have revealed the contribution of an initial high level of dengue virus replication to the severe and potentially life-threatening diseases dengue hemorrhagic fever (DHF) and dengue shock syndrome, the involvement of dengue virus in the immunopathological processes during the transition from fever to defervescence, which is a critical stage in determining the progression to DHF, has not been appreciated. Previously, we reported that dengue virus can be detected in the immune complexes of patients with DHF during this period.

METHODS

We investigated plasma dengue viral load, virus in immune complexes, antibody response, complements, and cytokines for 54 patients with dengue fever (a relatively mild form of disease) and 49 patients with DHF. The patients had confirmed secondary infection with dengue virus type 2 from a large outbreak in southern Taiwan in 2002.

RESULTS

Patients with DHF had a significantly higher viral load and a slower rate of clearance than patients with dengue fever. For viral loads >5.7 log RNA copies/mL on the day of defervescence, the positive and negative predictive values for DHF are 0.88 and 0.95, respectively. A higher level and slower decline of dengue virus-containing immune complexes (and a subsequently higher elevation of C5a and soluble interleukin 2 receptor) were found in patients with DHF, compared with patients with dengue fever.

CONCLUSIONS

These findings indicate that slower rates of clearance of viral load and virus-containing immune complexes are associated with subsequent immune activation and contribute to the progression of DHF at this critical stage. Moreover, viral load on the day of defervescence can predict cases of DHF.

Authors+Show Affiliations

Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, 100, Taiwan. wwang60@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16983615

Citation

Wang, Wei-Kung, et al. "Slower Rates of Clearance of Viral Load and Virus-containing Immune Complexes in Patients With Dengue Hemorrhagic Fever." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 43, no. 8, 2006, pp. 1023-30.
Wang WK, Chen HL, Yang CF, et al. Slower rates of clearance of viral load and virus-containing immune complexes in patients with dengue hemorrhagic fever. Clin Infect Dis. 2006;43(8):1023-30.
Wang, W. K., Chen, H. L., Yang, C. F., Hsieh, S. C., Juan, C. C., Chang, S. M., Yu, C. C., Lin, L. H., Huang, J. H., & King, C. C. (2006). Slower rates of clearance of viral load and virus-containing immune complexes in patients with dengue hemorrhagic fever. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 43(8), 1023-30.
Wang WK, et al. Slower Rates of Clearance of Viral Load and Virus-containing Immune Complexes in Patients With Dengue Hemorrhagic Fever. Clin Infect Dis. 2006 Oct 15;43(8):1023-30. PubMed PMID: 16983615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Slower rates of clearance of viral load and virus-containing immune complexes in patients with dengue hemorrhagic fever. AU - Wang,Wei-Kung, AU - Chen,Hui-Ling, AU - Yang,Chao-Fu, AU - Hsieh,Szu-Chia, AU - Juan,Chung-Chou, AU - Chang,Shu-Mei, AU - Yu,Cheng-Ching, AU - Lin,Li-Hui, AU - Huang,Jyh-Hsiung, AU - King,Chwan-Chuen, Y1 - 2006/09/14/ PY - 2006/03/22/received PY - 2006/07/05/accepted PY - 2006/9/20/pubmed PY - 2007/1/19/medline PY - 2006/9/20/entrez SP - 1023 EP - 30 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 43 IS - 8 N2 - BACKGROUND: Although previous studies have revealed the contribution of an initial high level of dengue virus replication to the severe and potentially life-threatening diseases dengue hemorrhagic fever (DHF) and dengue shock syndrome, the involvement of dengue virus in the immunopathological processes during the transition from fever to defervescence, which is a critical stage in determining the progression to DHF, has not been appreciated. Previously, we reported that dengue virus can be detected in the immune complexes of patients with DHF during this period. METHODS: We investigated plasma dengue viral load, virus in immune complexes, antibody response, complements, and cytokines for 54 patients with dengue fever (a relatively mild form of disease) and 49 patients with DHF. The patients had confirmed secondary infection with dengue virus type 2 from a large outbreak in southern Taiwan in 2002. RESULTS: Patients with DHF had a significantly higher viral load and a slower rate of clearance than patients with dengue fever. For viral loads >5.7 log RNA copies/mL on the day of defervescence, the positive and negative predictive values for DHF are 0.88 and 0.95, respectively. A higher level and slower decline of dengue virus-containing immune complexes (and a subsequently higher elevation of C5a and soluble interleukin 2 receptor) were found in patients with DHF, compared with patients with dengue fever. CONCLUSIONS: These findings indicate that slower rates of clearance of viral load and virus-containing immune complexes are associated with subsequent immune activation and contribute to the progression of DHF at this critical stage. Moreover, viral load on the day of defervescence can predict cases of DHF. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16983615/Slower_rates_of_clearance_of_viral_load_and_virus_containing_immune_complexes_in_patients_with_dengue_hemorrhagic_fever_ DB - PRIME DP - Unbound Medicine ER -