Predominant secondary dengue infection among Vietnamese adults mostly without warning signs and severe disease.

Autor:	Lytton SD; SeraDiaLogistics, Munich, Germany. Electronic address: simon.lytton@t-online.de., Nematollahi G; Institut Virion\Serion GmbH, 97076 Würzburg, Germany. Electronic address: g.nematollahi@virion-serion.de., van Tong H; Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Viet Nam. Electronic address: hoangvantong@vmmu.edu.vn., Xuan Anh C; 108 Military Central Hospital, Hanoi, Viet Nam. Electronic address: bsxuananh108@yahoo.com.vn., Hung HV; 103 Military Hospital, Vietnam Military Medical University, Hanoi, Viet Nam. Electronic address: drhoangvuhung@yahoo.com., Hoan NX; 108 Military Central Hospital, Hanoi, Viet Nam. Electronic address: nghiemxuanhoan@108-icid.com., Diez G; Institut Virion\Serion GmbH, 97076 Würzburg, Germany. Electronic address: g.diez@virion-serion.de., Schumacher T; Institut Virion\Serion GmbH, 97076 Würzburg, Germany. Electronic address: t.schumacher@virion-serion.de., Landt O; TIB MOLBIOL Syntheselabor GmbH D-12103 Berlin Germany. Electronic address: OLandt@tib-molbiol.de., Melchior W; SeraDiaLogistics, Munich, Germany. Electronic address: walter@drmelchior.org., Fuchs D; Division of Biological Chemistry, Innsbruck Medical University, Innsbruck, Austria. Electronic address: dietmar.fuchs@i-med.ac.at., Toan NL; Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Viet Nam. Electronic address: toannl@vmmu.edu.vn., Velavan TP; Vietnamese-GermanCenter for Medical Research, VG-CARE, Hanoi, Viet Nam; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany. Electronic address: velavan@medizin.uni-tuebingen.de., Song LH; 108 Military Central Hospital, Hanoi, Viet Nam; Vietnamese-GermanCenter for Medical Research, VG-CARE, Hanoi, Viet Nam. Electronic address: lehuusong@108-icid.com.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2020 Nov; Vol. 100, pp. 316-323. Date of Electronic Publication: 2020 Sep 05.
DOI:	10.1016/j.ijid.2020.08.082
Abstrakt:	Background: The morbidity in dengue fever is dependent on the dengue virus (DENV) serotypes, the patient age, predisposing immunogenic markers and the frequency of primary and secondary infections. This study aims to distinguish acute primary from secondary dengue infections of Vietnamese adults and to assess the association of viremia and anti-dengue immunoglobulin levels with clinical outcomes. Study Design: Viral RNA, dengue serotypes and levels of anti-dengue IgM and IgG of hospitalized adult cases were determined in EDTA-plasma samples prospectively collected during three consecutive years of dengue infection in Hanoi. Patients admitted to hospital within 7 days of their 1st reported fever were included. Primary infections were anti-dengue IgG enzyme-linked immunosorbent assay (ELISA) negative on both day of hospital entry (day 0) and day two or three of hospitalization (day 2 or 3) with a positive anti-dengue IgM on either day 0 or day 2 or 3 hospitalization. The secondary infections were anti-dengue IgG ELISA positive on both day 0 and day 2 or 3 with positive anti-dengue IgM ELISA on either day 0 or day 2 or 3. Results: The hospitalized dengue fever cases between October 2016 and March 2019 were predominantly secondary infections (74%, 68% and 77%, respectively) with DENV-1 (60% and 65%) and DENV-2 (22% and 26%) serotypes determined in the latter two years. The viremia in primary infection was significantly higher than that in secondary infection (P < 0.01) and positively correlated with the days of hospital stay. In secondary infections, platelet counts were lower than in primary infections (P = 0.04) and IgG levels in secondary infection negatively correlated with platelet counts (Spearman's r = -0.22, P < 0.01). Conclusions: Our results indicate high rates of secondary infection with DENV1 and DENV2 serotypes. Anti-dengue immunoglobulins negatively correlate with hospital stay and platelet counts with few warning signs or severe disease. Further investigations of specific antibodies in adults which predict auto-inflammatory activity after the recovery from dengue infection are warranted. (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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