Abstract
The objectives of the study were to compare the DENV NS1 and nucleic acid positivity in dengue fever (DF) and dengue haemorrhagic fever (DHF) patients and to evaluate the usefulness of these parameters in severe dengue. Blood samples were collected from 91 patients with DF or DHF (fever days 3–9) from Gampaha and Negombo General Hospitals, Sri Lanka and tested for DENV NS1 antigen and nucleic acid. On fever day 3, 67% of the DF and 33% of the DHF patients had DENV nucleic acid whereas 50% of the DF and 67% of the DHF patients had NS1. On fever day 4, 67% of the DF and 100% of the DHF patients had DENV nucleic acid whereas 83% of the DF and DHF patients had NS1. From fever day 5 in the DHF group, DENV nucleic acid declined but NS1 remained detectable even on day 9 (p < 0.0001). NS1 positivity did not correlate with the decrease in the WBC count in DF and DHF patients (p > 0.05) whereas NS1 positivity significantly correlated with the decrease in the platelet count in DF and DHF patients (p < 0.0001). NS1 is a useful marker to detect DENV infection even in the latter stages of DHF.
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References
Senaratne TN, Noordeen F. Diagnosis of dengue in Sri Lanka: improvements to the existing state of the art in the island. Trans R Soc Trop Med Hyg. 2014;108:685–91.
Vijayakumar TS, Chandy S, Sathish N, Abraham M, Abraham P, Sridharan G, et al. Is dengue emerging as a major public health problem? Indian J Med Res. 2005;121:100–7.
Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, Hunsperger E, Kroeger A, Margolis HS, Martínez E, Nathan MB, Pelegrino JL, Simmons C, Yoksan S, Peeling RW. Dengue: a continuing global threat. Nature Rev in Microbiol. doi: 10.1038/nrmicro2460.
Senaratne T, Wimalaratne H, Alahakoon DGS, Gunawardane N, Carr J, Noordeen F. Characterization of dengue virus infections in a sample of patients suggests unique clinical, immunological and virological profiles that impact on the diagnosis of dengue and dengue haemorrhagic fever. J Med Virol. 2016;88:1703–10.
Jacobs MG, Robinson PJ, Bletchly C, Mackenzie JM, Young PR. Dengue virus nonstructural protein 1 is expressed in a glycosyl-phosphatidylinositol-linked from that is capable of signal transduction. FASEB J. 2000;14:1603–10.
Alcon S, Talarmin A, Debruyne M, Falconar A, Deubel V, Flamand M. Enzyme-linked immunosorbent assay specific to dengue virus type 1 non-structural protein NS1 reveals circulation of the antigen in the blood during the acute phase of disease in patients experiencing primary or secondary infections. J Clin Microbiol. 2002;40:376–81.
Lanciotti RS, Calisher CH, Gubler DJ, Chang GJ, Vorndam AV. Rapid detection and typing of dengue viruses from clinical samples by using reverse transcriptase- polymerase chain reaction. J Clin Microbiol. 1992;30:545–51.
Dussart P, Petit L, Labeau B, Bremand L, Leduc A, Moua D, Matheus S, Baril L. Evaluation of two new commercial tests for the diagnosis of acute dengue virus infection using NS1 antigen detection in human Serum. PLoS Negl Trop Dis. doi: 10.1371/journal.pntd.0000280.
Kumarasamy V, Wahab AH, Chua SK, Hassan Z, Chem YK, Mohamad M, Chua KB. Evaluation of a commercial dengue NS1 antigen-capture ELISA for laboratory diagnosis of acute dengue virus infection. J Virol Methods. 2007;140:75–9.
Chuansumrit A, Chaiyaratana W, Pongthanapisith V, Tangnararatchakit K, Lertwongrath S, Yoksan S. The use of dengue nonstructural protein 1 antigen for the early diagnosis during the febrile stage in patients with dengue infection. Pediatr Infect Dis J. 2008;27:43–8.
Libraty DH, Young PR, Pickering D, Endy TP, Kalayanarooj S, Green S, Vaughn DW, Nisalak A, Ennis FA, Rothman AL. High circulating levels of the dengue virus non-structural protein NS1 early in dengue illness correlate with the development of dengue hemorrhagic fever. J Infect Dis. 2002;86:1165–8.
Hang VT, Nguyet NM, Trung DT, Tricou V, Yoksan S, Dung NM, Ngoc TV, Hien TT, Farrar J, Wills B, Simmons CP. Diagnostic accuracy of NS1 ELISA and lateral flow rapid tests for dengue sensitivity, specificity and relationship to viraemia and antibody responses. PLoS Negl Trop. Dis DrosophilaInfServ. 2009;3:e360.
Thomas L, Najioullah F, Verlaeten O, Martial J, Brichler S, Kaidomar S, Moravie V, Cabié A, Césaire R. Relationship between nonstructural protein 1 detection and plasma virus load in Dengue patients. Am J Trop Med Hyg. 2010;83:696–9.
Lin SF, Liu HW, Chang CS, Yen JH, Chen TP. Hematological aspects of dengue fever. Gaoxiong Yi Xue Ke Xue Za Zhi. 1989;5(1):12–61.
Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev. 2009;22(564–581):1.
Falconar AK. The dengue virus non-structural-1 protein (NS1) generates antibodies to common epitopes on human blood clotting, integrin/adhesin proteins and binds to human endothelial cells: potential implications in haemorrhagic fever pathogenesis. Arch Virol. 1997;142:897–916.
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We thank the National Research Council (NRC), Sri Lanka for funding the study through a research grant RG/NRC/11-129 to Prof F Noordeen.
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Sirisena, N., Noordeen, F. & Fernando, L. NS 1 lasts longer than the dengue virus nucleic acid in the clinically suspected patients with dengue fever and dengue haemorrhagic fever. VirusDis. 28, 341–344 (2017). https://doi.org/10.1007/s13337-017-0401-9
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DOI: https://doi.org/10.1007/s13337-017-0401-9