Abstract
Objectives Plasma leakage, a hallmark of disease in Dengue virus (DENV) infection, is an important clinical manifestation and is often associated with numerous factors such as viral factors. The aim of this study is to investigate the association of virus serotype, viral load kinetics, history of infection, and NS1 protein with plasma leakage. Methods Subjects with fever ≤ 48 hours and positive DENV infection were included. Serial laboratory tests, viral load measurements, and ultrasonography examination to assess plasma leakage were performed. Results DENV-3 was the most common serotype found in the plasma leakage group (35%). Patients with plasma leakage demonstrated a trend of higher viral load and a longer duration of viremia compared to those without. This was significantly observed on the fourth day of fever (p = 0.037). We found higher viral loads on specific days in patients with plasma leakage in both primary and secondary infections compared to those without. In addition, we also observed more rapid viral clearance in patients with secondary infection. NS1 protein, especially after 4 days of fever, was associated with higher peak viral load level, even though it was not statistically significant (p = 0.470). However, pairwise comparison demonstrated that peak viral load level in the group of patients with circulating NS1 detected for 7 days was significantly higher than the 5-day group (p = 0.037). Conclusion DENV-3 was the most common serotype to cause plasma leakage. Patients with plasma leakage showed a trend of higher viral load and a longer duration of viremia. Higher level of viral load was observed significantly on day 5 in patients with primary infection and more rapid viral clearance was observed in patients with secondary infection. Longer duration of circulating NS1 protein was also seen to be positively correlated with higher peak viral load level although not statistically significant.
| Original language | English |
|---|---|
| Article number | e0285087 |
| Journal | PLoS ONE |
| Volume | 18 |
| Issue number | 5 5 |
| DOIs | |
| Publication status | Published - 2 May 2023 |
Bibliographical note
Funding Information:The study was financially supported by the Indonesian Science Fund grant (08/DIPI/2017-MR/PO17509/1), Indonesian Ministry of Education, Culture, Research, and Technology grant (PUTI Q2 582/UN2.RST/HKP.05.00/2022) and internal grants from the Department of Internal Medicine and the Department of Microbiology, Faculty of Medicine Universitas Indonesia. The funders had no role in study design, data collection, data analyses, decision to publish or preparation of the manuscript."
Publisher Copyright:
© 2023 Nainggolan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
