High levels of plasma dengue viral load during defervescence in patients with dengue hemorrhagic fever: Implications for pathogenesis

Wei Kung Wang, Day Yu Chao, Chuan Liang Kao, Han Chung Wu, Yung Ching Liu, Chien Ming Li, Shih Chung Lin, Shih Ting Ho, Jyh Hsiung Huang, Chwan Chuen King

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Studies of the pathogenesis of dengue hemorrhagic fever (DHF), a potentially life-threatening disease, have revealed the importance of initial high levels of virus replication. However, the possible involvement of virus during the transition from fever to defervescence, a critical stage in determining the severity of disease, has not been appreciated. Using quantitative reverse transcription-polymerase chain reaction, we examined the levels of plasma dengue viral load during both fever and defervescence periods in patients from a DEN-3 outbreak in southern Taiwan in 1998. Higher levels of plasma dengue viral RNA were found in DHF patients than in DF patients. During defervescence, while the level of plasma dengue viral RNA was undetectable in most DF patients, it remains high in all DHF patients. Using a modified immunoprecipitation assay, we demonstrated for the first time that the plasma dengue viruses persisting during defervescence were in the immune complexes for most DHF patients. These findings suggest that continued active viral replication or delay in the clearance of viremia contributes to the pathogenesis of DHF. Moreover, high levels of plasma dengue viral RNA during defervescence may serve as a disease marker for DHF.

Original languageEnglish
Pages (from-to)330-338
Number of pages9
JournalVirology
Volume305
Issue number2
DOIs
Publication statusPublished - Jan 20 2003
Externally publishedYes

Keywords

  • Dengue virus
  • Immune complex
  • Pathogenesis
  • Quantification
  • RT-PCR

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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  • Cite this

    Wang, W. K., Chao, D. Y., Kao, C. L., Wu, H. C., Liu, Y. C., Li, C. M., Lin, S. C., Ho, S. T., Huang, J. H., & King, C. C. (2003). High levels of plasma dengue viral load during defervescence in patients with dengue hemorrhagic fever: Implications for pathogenesis. Virology, 305(2), 330-338. https://doi.org/10.1006/viro.2002.1704