The impact of dengue haemorrhagic fever on liver function

The impact of dengue haemorrhagic fever (DHF) on liver function was studied by measuring serum transaminase levels on 45 patients with DHF confirmed by virus isolation and serodiagnosis in 1995. Abnormal levels of AST and ALT were observed in 97.7 and 37.3% of the patients, respectively. The fact that the level of AST was higher than that of ALT and that the elevation of transaminases was mild to moderate in most cases (< 5-fold greater than the normal upper limit for AST and ALT) showed that liver involvement was also mild to moderate in most cases of DHF. The results of transaminases did not differ significantly between cases with and without hepatitis B or hepatitis C virus infection, nor between primary and secondary cases of infection, but a significantly higher elevation of AST and ALT was observed in DHF patients with gastrointestinal haemorrhage. Two patients with dengue encephalopathy (in 1992) and one patient with dengue encephalopathy who died of massive gastrointestinal haemorrhage (in 1995) had unusually high transaminase levels as a sign of acute liver failure. It is concluded that DHF may cause mild to moderate liver dysfunction in most cases; only some patients may suffer from acute liver failure leading to encephalopathy and death.