Profile of Hepatic Involvement by Dengue Virus in Dengue Infected Children

Background: The spectrum of liver dysfunction in children with dengue infection is wide and has been associated with disease severity. Aims: This study was undertaken to estimate the range of hepatic involvement in dengue infection in children. Materials and Methods: This study assessed the biochemical and clinical profile of hepatic involvement by dengue virus in 120 children with serologically positive dengue fever (DF), aged 2 months to 14 years. Results: All cases were grouped into DF without warning signs (Group 1), DF with warning signs (Group 2) and severe dengue (Group 3) according to revised World Health Organization 2009 criteria. The spectrum of hepatic manifestations included hepatomegaly (80.8%), hepatic tenderness (46.3%), jaundice (60%), raised aspartate transaminase (AST), alanine transaminase (ALT) and prolonged prothrombin time (41.7%) and reduced serum albumin (56%). Conclusions: Hepatic dysfunction was observed more in Groups 2 and 3. There was 84.4% and 93.75% ALT and AST elevation respectively in Group 2 and 94.5% and 95.9% ALT and AST elevation respectively in Group 3 and fulminant hepatic failure was observed in Group 3. Therefore in a child with fever, jaundice, hepatomegaly and altered liver function tests, the diagnosis of dengue infection should be strongly considered in areas where dengue infection is endemic.