Abstract

Background: Hepatic enzymes derangement is common in Dengue viral infection. The degree of derangement may be from mild rise in serum Aminotransferase level to acute fulminant hepatitis. The degree of derangement is evaluated by measuring the serum Aminotransferase and serum bilirubin level in dengue patients. The hepatic enzyme derangement can be categorised on the basis of serum Aminotransferase and bilirubin level.

Objective: The objective of this study is to evaluate the effect of Dengue virus infection on hepatic enzymes. This effect is studied by measuring the Aminotransferase and bilirubin level.

Material and Methods: This study was conducted for a period of two years at the department of Microbiology, Nalanda Medical College, Patna, Bihar. The degree of hepatic dysfunction is categorised into category A- in which there is normal or near normal  serum Aminotransferase and bilirubin level; category B- in which the rise in Aminotransferase level is up to five times of normal value but normal serum bilirubin level; category C- the rise in serum Aminotransferase level is greater than five times but less than ten times of normal value with or without rise in serum bilirubin level; category D- patient with acute hepatitis and rise in serum Aminotransferase level greater than ten times of the normal with or without rise in serum bilirubin level.

Result: There are 240 confirmed patients of dengue virus infection. Patients are grouped into Group A, B, C & D depending on the level of serum Aminotransferase. The number of patients belonging to Group A are 144(60.2%), belonging to Group B are 60(24.8%), Group C are 29(12.4%) and Group D are 07(2.6%). Thrombocyte count varies from 11,000 to 170,000. Mean AST level varies from 48.3 to 1900.5 and mean ALT level varies from 45.8 to 1800.6 in Group A to D.

Discussion and Conclusion: Hepatic dysfunction is common complication of Dengue infection. Although mild hepatic dysfunction with rise in hepatic enzymes is common in Dengue infection but fulminant hepatitis is rare. The diagnosis of hepatic enzymes derangement can be easily done by AST and ALT measurement.

Keywords: Dengue fever, NS1 antigen, IgM antibody, AST, ALT, ALP, Hepatitis, Fulminant, Aminotransferase, Dengue hemorrhagic fever.