Liver Transaminases as a Predictor of Dengue Hemorrhagic Fever

Abstract

Objective: Elevation of serum liver transaminase is common during dengue infection. A group of dengue patients was studied to determine the relationship between the elevation of liver transaminases in dengue fever (DF) and dengue hemorrhagic fever (DHF). Methodology: This study was conducted to assess the predictive value of liver enzymes for DHF. During the dengue epidemic of 2017, all data pertaining to 601 dengue patients were collected in a systematic manner for purposes of conducting an analysis on the predictive value of serum levels of liver transaminase for DHF. Six hundred one patients were categorized into DF and DHF, according to the World Health Organization 2009 Dengue Management Guidelines. The data were collected retrospectively. Results: There were significant differences between aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels among DF and DHF patients, not only on day 5 of the critical phase but also during the acute febrile phase. The area under the ROC curve at the acute febrile phase for AST was 0.7, but in ALT, it was 0.6. However, the area under the ROC curve was 0.70, which indicates that AST at the acute febrile phase is a good indicator of the leaking tendency. According to the coordinate points of the curve, leaking can be predicted with a sensitivity of 72% and a specificity of 60% at an AST value of 59.5. Conclusion: The AST value of 59.5 at the acute febrile phase can be used to predict DHF. However, patients who have significantly elevated transaminase levels during the acute febrile phase have a higher tendency to develop DHF.