Dengue and Dengue Hemorrhagic Fever among Adults: Clinical Outcomes Related to Viremia, Serotypes, and Antibody Response

Guilarde, Adriana Oliveira; Turchi, Marília Dalva; Siqueira, João Bosco; Feres, Valéria Christina Rezende; Rocha, Benigno Alberto Moraes da; Levi, José Eduardo; Souza, Vanda Akico Ueda Fick de; Boas, Lucy S. Vilas; Pannuti, Cláudio Sérgio; Martelli, C. M. T.

doi:10.1086/528805

Cited by 149 publications

(132 citation statements)

References 40 publications

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“…This finding is in agreement with the fact that dengue is an acute infectious disease, which affects persons independent of their previous health status. 2,41 Most of the patients in our study were classified as having DF. In a study in Malaysia in which patients were assessed by using the same instrument, patients generally had more severe dengue (DHF or DF with plasma leakage).…”

Section: Discussionmentioning

confidence: 94%

Quality of Life among Adults with Confirmed Dengue in Brazil

Martelli¹,

Nascimento²,

Suaya³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. The main objective of this study was to measure the quality of life (QoL) during a dengue episode. We conducted a facility-based survey in central Brazil in 2005 and recruited 372 laboratory-confirmed dengue patients greater than 12 years of age in hospital and ambulatory settings. We administered the World Health Organization QoL instrument approximately 15 days after the onset of symptoms. We used principal component analysis with varimax rotation to identify domains related to QoL. The median age of interviewees was 36 years. Most (85%) reported their general health status as very good or good before the dengue episode. Although ambulatory patients were mainly classified as having dengue fever, 44.8% of hospitalized patients had dengue hemorrhagic fever or intermediate dengue. Principal component analysis identified five principal components related to cognition, sleep and energy, mobility, self-care, pain, and discomfort, which explained 73% of the variability of the data matrix. Hospitalized patients had significantly lower mean scores for dimensions cognition, self-care, and pain than ambulatory patients. This investigation documented the generally poor QoL during a dengue episode caused by the large number of domains affected and significant differences between health care settings.

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Section: Discussionmentioning

confidence: 94%

Quality of Life among Adults with Confirmed Dengue in Brazil

Martelli¹,

Nascimento²,

Suaya³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…The data imply that the differences between serotypes and viral load can contribute to determine disease progression. 4,9,34 In our study, we examined the levels of immunoregulatory cytokines IL-6, IL-8, and IL-10 to gain greater insights into possible roles for these cytokines in the earliest phases of disease development, between days 1 and 4 of the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Dengue Patients with Early Hemorrhagic Manifestations Lose Coordinate Expression of the Anti-Inflammatory Cytokine IL-10 with the Inflammatory Cytokines IL-6 and IL-8

Iani¹,

Caldas

Duarte

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Dengue is responsible for a wide range of clinical manifestations, ranging from asymptomatic infections to severe cases. The alteration of cytokine levels correlated with clinical characteristics can help determine prognostic markers of the disease and the identification of targets for immunotherapy. We measured the viral load, serotype, and cytokine levels of 212 serum samples from patients with acute dengue infection during days 1-4 after the onset of symptoms. The patients were classified as either with hemorrhagic manifestations (HM) or with no hemorrhagic manifestations (NHM). The cytokines interleukin-6 (IL-6), IL-8, and IL-10 were increased (P < 0.05) in the dengue virus+ group, compared with the control group. A higher viral load (P < 0.05) and IL-6 was detected in the HM group compared with the NHM group. Interestingly, the NHM group demonstrated a significant positive correlation between inflammatory (IL-6 and 8) and anti-inflammatory (IL-10) cytokines, whereas the HM group did not. These findings suggest that a disturbance in the balance of inflammatory cytokines IL-6 and IL-8 with the anti-inflammatory cytokine, IL-10, combined with the high levels of IL-6 and viral load, characterize possible mechanisms related to the formation of HM.

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“…More recently, many cases of dengue hemorrhagic fever have been diagnosed in patients without primary dengue infection, that is, individuals without antibodies from previous infections 37,40 . Since such cases do not fit with the premises of the Halstead hypothesis of sequential infections 4 , research is needed to elucidate which other factors are involved, such as viral strain virulence, as reported since the 1970s 41 , host genetics 32 , presence of co-morbidtiy 37,39 , and others that can contribute to dengue severity.…”

Section: Revisiting Dengue Epidemiology In Brazilmentioning

confidence: 99%