Liver function tests in patients with dengue viral infection.

ABSTRACT

To assess the frequency and degree of hepatic dysfunction in patients with dengue infection, records of214 serologically confirmed cases of dengue infection with available biochemical liver tests, admittedto our tertiary-care institute, were analysed. Patients were classified as classical dengue fever (DF) –81.3%, dengue haemorrhagic fever (DHF) – 13.6% and dengue shock syndrome (DSS) – 5.1%. Themean age was 31.6 years (malefemale = 3.31). Deranged total bilirubin, aspartate aminotransferase(AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), albumin and prothrombin timeindex (PTI) [international normalized ratio (INR)] was present in 19.5% (29/143), 97.7% (209/214),93.9% (199/214), 32.6% (47/144), 29.1% (44/151) and 15.5% (22/156) patients respectively. Themean (± SE) total bilirubin, AST, ALT, ALP, albumin and INR values were 0.93 ± 0.09 mg/dl, 353.7 ±49.6 U/L, 218.6 ± 27.2 U/L, 135.2 ± 6.5 U/L, 3.2 ± 0.04 g/dl and 1.2 ± 0.03 respectively. The meanvalue of AST was significantly higher than ALT. The degree of rise of AST and ALP was significantly morein DHF and DSS, as compared to DF; but the frequency of rise was similar in all groups. Mean serumbilirubin, ALT and ALP values were significantly higher in patients with haemorrhage as compared tothose without haemorrhage, in patients with secondary dengue infection as compared to primary infection, and in non-survivors. Hepatic dysfunction was very common in all forms of dengue infection,with AST rising significantly more than ALT. Serum bilirubin, ALT and ALP were significantly higher inpatients with DSS, haemorrhage, sequential infection and non-survivors. While preferentially high AST may serve as an early indicator of dengue infection, high bilirubin, ALT and ALP may act as poorprognostic markers.