Predicting acute liver failure in dengue infection

Area of Science:

• Hepatology
• Infectious Diseases
• Clinical Medicine

Background:

• Dengue virus infection is a significant global health concern.
• Acute liver failure (ALF) is a rare but severe complication of dengue infection.
• Early identification of patients at risk for ALF is crucial for timely intervention.

Purpose of the Study:

• To identify early clinical and biochemical predictors of acute liver failure (ALF) in patients with dengue infection.
• To evaluate the predictive value of specific symptoms and laboratory findings for ALF development.

Main Methods:

• Retrospective analysis of 240 patients diagnosed with dengue infection.
• Assessment of serum aspartate aminotransferase (AST), bilirubin, and alkaline phosphatase levels.
• Evaluation of symptoms including nausea, vomiting, and jaundice within the first 5 days of illness.

Main Results:

• Patients with serum AST > 1000 IU/ml were at higher risk of developing ALF.
• The presence of two out of three factors (elevated serum bilirubin, elevated alkaline phosphatase, persistent nausea/vomiting) within 5 days of illness predicted ALF in patients with AST > 1000 IU/ml with high sensitivity and specificity.
• These predictors demonstrated high positive (83.3%) and negative (99%) predictive values for ALF.

Conclusions:

• Elevated AST (>1000 IU/ml) in early dengue infection is a critical indicator for monitoring ALF risk.
• A combination of elevated bilirubin, alkaline phosphatase, and persistent nausea/vomiting in the early phase of dengue infection strongly predicts impending ALF.
• Physicians should be vigilant for these warning signs in dengue patients with significantly elevated AST to prevent severe outcomes.