Abstract
ABSTRACT INTRODUCTION: Dengue virus (DENV) infection has been considered a major public health problem in tropical countries. The unavailability of serologic testing in public health centers might adversely impact patients' outcome. OBJECTIVE: This study aimed to evaluate the accuracy of mean platelet volume (MPV) and aspartate aminotransferase (AST) to platelet ratio index (APRI) as laboratory markers of DENV infection that could be used to differentiate primary and secondary infections. METHODS: We assessed laboratory results from 503 patients with positive rapid test for DENV infection. RESULTS: Severe thrombocytopenia and increased liver involvement were observed in patients with DENV heterotypic secondary infection. Our data suggest that APRI was able to distinguish patients with primary and secondary infection (p = 0.006) with a relevant sensitivity (75%), specificity (76%) and a cut-off of 1.06. A total of 80 out of 105 (76%) patients with primary DENV infection had APRI ≤ 1.06, and 12 (75%) with secondary DENV infection had APRI > 1.06. On the other hand, MPV did not show significance in the differentiation of types of infection, coming up with poor area under the receiver operating characteristic (ROC) curve (0.61). CONCLUSION: APRI seems to be a powerful tool for early identification of DENV secondary infection cases in health centers.
Highlights
Dengue virus (DENV) infection has been considered a major public health problem in tropical countries
This study aimed to evaluate the accuracy of mean platelet volume (MPV) and aspartate aminotransferase (AST) to platelet ratio index (APRI) as laboratory markers of DENV infection that could be used to differentiate primary and secondary infections
We aim to evaluate the accuracy of MPV and AST to platelet ratio index (APRI) as laboratory markers of DENV infection that could be used to differentiate primary and secondary infections with a better cost-benefit than current gold standard tests
Summary
Dengue virus (DENV) infection has been considered a major public health problem in tropical countries. Results: Severe thrombocytopenia and increased liver involvement were observed in patients with DENV heterotypic secondary infection. A total of 80 out of 105 (76%) patients with primary DENV infection had APRI ≤ 1.06, and 12 (75%) with secondary DENV infection had APRI > 1.06. Conclusion: APRI seems to be a powerful tool for early identification of DENV secondary infection cases in health centers. Dengue virus (DENV) infection is a global public health problem and a human vector-borne viral disease. The more severe types of dengue infection, known as dengue hemorrhagic fever/ dengue shock syndrome (DHF/DSS), are commonly caused by secondary infection, when an individual with a previous history of dengue is subsequently infected with a second virus serotype. DHF/ DSS is characterized by coagulopathy, increased vascular fragility, and loss of fluid due to capillary permeability that may progress to hypovolemic shock[7]
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