Clinical and Epidemiological Profile of Liver Dysfunction in Dengue Fever - A Cross-Sectional Study

Dengue fever is a major public health concern in tropical and subtropical regions, including Kerala, India. Hepatic involvement is a common but variable feature of the disease, ranging from asymptomatic transaminitis to acute liver failure.

We conducted a single-center, observational, cross-sectional study over a 6-month period. Adult patients (≥18 years) with laboratory-confirmed dengue fever (NS1 antigen or IgM ELISA positive) were enrolled consecutively. Detailed clinical and demographic data were collected. Liver function tests, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), were monitored. Hepatic dysfunction was defined as an elevation of AST or ALT >2.5 times the upper limit of normal (>100 IU/L).

A total of 216 patients were included (mean age 42.5 ± 16.1 years; 56.5% male). The overall incidence of hepatic dysfunction was 64.4% (139/216). A characteristic pattern of AST elevation greater than ALT was observed, with peak AST levels noted on day 4 of admission. The most common symptoms were fever (100%), myalgia (76.4%), and fatigue (69.9%). Patients with hepatic dysfunction had a significantly longer duration of hospital stay compared to those without (median 5 days vs. 3 days; P = 0.005). Furthermore, the need for platelet transfusion was significantly higher in the group with hepatic involvement (12.2% vs. 1.3%; P = 0.005). No mortalities were recorded in the cohort.

Hepatic dysfunction is a frequent complication among hospitalized dengue patients in South Kerala and is associated with a more protracted clinical course, including longer hospital stays and a greater need for platelet transfusions.