在发烧阶段的病毒载荷是否是登革热疾病严重程度的预测因素?
Shashika Dayarathna1, Heshan Kuruppu1, Tehani Silva1,2
1Allergy Immunology and Cell Biology Unit, Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
BMC infectious diseases
|November 5, 2024
概括
在斯里兰卡的一项研究中,在早期登革热期间的病毒性血与疾病严重程度没有显著的相关性. 病毒载量因登革热病毒 (DENV) 血清型而异,但没有预测登革热出血性发烧等临床结果.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 在登革热疾病中,病毒性血症与临床疾病严重程度之间的关联存在相互矛盾的结果.
- 了解这种关系对于预测患者的结果和管理疫情至关重要.
研究的目的:
- 调查早期登革热病期间的病毒血和随后的临床疾病严重程度之间的关联.
- 分析登革热病毒 (DENV) 血清型之间的病毒载荷差异及其与疾病进展的相关性.
主要方法:
- 在斯里兰卡科伦坡 (2017-2022) 研究了一组362名登革热患者,这些患者在症状出现后4天内出现了登革热.
- 实时PCR被用于识别DENV血型和量化病毒载荷.
- 每天对患者进行监测,并使用世卫组织标准 (1997年和2009年) 将疾病严重程度分类.
主要成果:
- 虽然DENV血清型 (p=0.0009) 之间病毒载量有显著差异,其中DENV3显示最高,DENV2显示最低负载,但它们与整体临床疾病严重程度没有显著相关.
- 然而,DENV2感染与患登革热出血热 (DHF) 的风险增加显著相关 (p=0.011,或1.9).
- 在没有预警症状的登革热患者,有预警症状的登革热患者和严重的登革热患者之间,没有观察到病毒载荷的显著差异.
结论:
- 登革热病毒 (DENV) 血清型在发烧阶段表现出明显的病毒载荷模式.
- 早期登革热病的病毒血水平似乎不是斯里兰卡队列中随后临床疾病严重性的重要预测指标.
- DENV2感染值得进一步调查,因为它与不依赖于病毒载量的较高DHF风险有关.
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