<p>Repurposing of N-Acetylcysteine for the Treatment of Dengue Virus-Induced Acute Liver Failure</p>

Abstract

The prevalence of dengue infection-induced acute liver damage is increasing from time to time. Since it has no specific antiviral treatment in the world, people in endemic areas suffer more from dengue disorders. Thus, there is a need for searching options for the treatment of dengue-induced acute liver failure. N-acetylcysteine, which is used for the treatment of nasal congestion disorder and paracetamol overdose toxicity, could be used as a definitive therapy for dengue virus-induced acute liver disease. Therefore, this review discusses the therapeutic use of N-acetylcysteine for dengue-induced acute liver disease. Various case reports and case series showed that patients received NAC recovered from their clinical status. Additionally, a preclinical study showed that N-acetylcysteine has anti-dengue virus activity. Thus, N-acetylcysteine could be used as a definitive therapy in dengue virus-induced hepatitis. This might encourage researchers to further investigate the importance of N-acetylcysteine for dengue virus-induced hepatitis.

Falla hepática aguda inducida por dengue

“…La FHA por dengue no tiene un tratamiento específico, sin embargo, dentro del ejercicio terapéutico conviene identificar aquellos pacientes con enfermedad hepática crónica, excluir enfermedades hepatobiliares tratables o emergentes, considerar el riesgo individual de pacientes con condiciones específicas como los diabéticos y excluir etiologías como la lesión hepática inducida por fármacos (DILI), debido a que son grupos de riesgo (16). El uso de N-acetil-cisteína por su actividad antioxidante, ha sido descrito en múltiples reportes de casos generalmente con buenos resultados cuando se usa de manera temprana en pacientes con encefalopatía hepática por DENV (17). El uso actual de sistemas no biológicos como el de recirculación molecular adsorbente (MARS, por sus siglas en ingles), se ha practicado con seguridad en FHA de diferentes etiologías, mostrando beneficios sobre la ictericia, la inestabilidad hemodinámica, la hipertensión portal y endocraneana, y la encefalopatía hepática con reportes favorables en la FHA por dengue (18).…”

Variations of dengue shock syndrome cases and their management: report of three cases

“…NAC can also reduce dengue virus infectivity during admission, replication, post-translation, RNA synthesis, and exocytosis. 6, 16 In a retrospective analysis, the dose of NAC given was intravenously 100 mg/kg/day for 5 days, followed by 12.5 mg/day. kgBW/hour for 4 hours followed by 6.25 mg/kgBW/hour for 72 hours.…”

Acute Liver Failure in Dengue: A Common but Overlooked Entity in Pediatric Patients in Tropical Countries

“…Management of ALF in dengue infection is largely supportive in an intensive care setting. Some of the centers have used NAC in adults with variable results but it is not part of our management protocol and its use was sporadic (21,22). We did not find any significant difference in survival with the use of NAC though Sriphongphankul et al (16) from Thailand found it to be beneficial in dengue PALF.…”