Clinical and Immunological Markers of Dengue Progression in a Study Cohort from a Hyperendemic Area in Malaysia

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dc.contributor.authorRathakrishnan, Anusyah
dc.contributor.authorKlekamp, Benjamin
dc.contributor.authorSeok, Mui Wang
dc.contributor.authorKomarasamy, Thamil Vaani
dc.contributor.authorNatkunam, Santha Kumari
dc.contributor.authorSathar, Jameela
dc.contributor.authorAzizan, Azliyati
dc.contributor.authorSanchez-Anguiano, Aurora
dc.contributor.authorManikam, Rishya
dc.contributor.authorDevi Sekaran, Shamala
dc.date.accessioned2015-12-30T05:04:49Z
dc.date.available2015-12-30T05:04:49Z
dc.date.issued2014-03
dc.description.abstractBackground: With its elusive pathogenesis, dengue imposes serious healthcare, economic and social burden on endemic countries. This study describes the clinical and immunological parameters of a dengue cohort in a Malaysian city, the first according to the WHO 2009 dengue classification. Methodology and Findings: This longitudinal descriptive study was conducted in two Malaysian hospitals where patients aged 14 and above with clinical symptoms suggestive of dengue were recruited with informed consent. Among the 504 participants, 9.3% were classified as non-dengue, 12.7% without warning signs, 77.0% with warning signs and 1.0% with severe dengue based on clinical diagnosis. Of these, 37% were misdiagnosed as non-dengue, highlighting the importance of both clinical diagnosis and laboratory findings. Thrombocytopenia, prolonged clotting time, liver enzymes, ALT and AST served as good markers for dengue progression but could not distinguish between patients with and without warning signs. HLA-A*24 and -B*57 were positively associated with Chinese and Indians patients with warning signs, respectively, whereas A*03 may be protective in the Malays. HLA-A*33 was also positively associated in patients with warning signs when compared to those without. Dengue NS1, NS2A, NS4A and NS4B were found to be important T cell epitopes; however with no apparent difference between with and without warning signs patients. Distinction between the 2 groups of patients was also not observed in any of the cytokines analyzed; nevertheless, 12 were significantly differentially expressed at the different phases of illness.ru_RU
dc.identifier.citationRathakrishnan A, Klekamp B, Wang SM, Komarasamy TV, Natkunam SK, et al. (2014) Clinical and Immunological Markers of Dengue Progression in a Study Cohort from a Hyperendemic Area in Malaysia. PLoS ONE 9(3): e92021. doi:10.1371/journal.pone.0092021ru_RU
dc.identifier.urihttp://nur.nu.edu.kz/handle/123456789/984
dc.language.isoenru_RU
dc.publisherClinical Epidemiology of a Malaysian Dengue Cohortru_RU
dc.subjectMalaysiaru_RU
dc.subjectimmunological markersru_RU
dc.subjectdengueru_RU
dc.subjectCohortru_RU
dc.titleClinical and Immunological Markers of Dengue Progression in a Study Cohort from a Hyperendemic Area in Malaysiaru_RU
dc.typeArticleru_RU

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