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Dengue hepatitis: Incidence, spectrum and outcome

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Abstract

Background and Aims

While dengue infection is common in India, there is scarce information on dengue hepatitis. The aim of this study was to analyze the incidence, spectrum and outcome of dengue hepatitis.

Methods

We retrospectively analyzed consecutive patients, who had hepatitis among those with dengue infection admitted to two tertiary care hospitals in western India from January 2016 to March 2021. Diagnosis of dengue infection was made by serology. Dengue hepatitis was diagnosed and the severity of dengue was categorized by standard criteria.

Results

Of 1664 patients admitted with dengue fever during the study period, 199 patients had hepatitis (i.e. incidence of dengue hepatitis was 11.9%). Of the 199 dengue hepatitis patients (age: 29 [13 – 80] years, median [range], 67% males), 100 patients (50%) had severe dengue, 73 (36%) had severe dengue hepatitis, 32 (16%) had dengue shock syndrome and eight (4%) had acute liver failure. Forty-five patients (23%) had acute lung injury and 32 (16%) had acute kidney injury. The dengue hepatitis patients were treated with standard medical care, including vital organ support, as needed—166 (83%) patients survived, while 33 patients (17%) died (cause of death: multi-organ failure: 24 patients, septic shock: nine patients). The presence of shock independently predicted mortality (odds ratio 6.4, 95% confidence interval: 1.2 – 34). Among patients with dengue hepatitis, mortality rate was higher in those with severe dengue (23%), dengue shock syndrome (47%), severe dengue hepatitis (24%) and acute liver failure (38%).

Conclusion

In this large series of hospitalized patients with dengue infection, the incidence of dengue hepatitis was 11.9%. Among 199 dengue hepatitis, 17% died; multi-organ failure was the commonest cause for death and death rate was higher in patients with more severe disease. The presence of shock at presentation independently predicted mortality.

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Supporting data will be made available as and when required.

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Authors and Affiliations

  1. Department of Gastroenterology, Surat Institute of Digestive Sciences, Majura Gate, Ring Road, Surat, 395 002, India

    Ritesh Prajapati, Rajiv Mehta, Mayank Kabrawala, Subhash Nandwani, Nisharg Patel, Mohit Sethia, Kamlesh Magnani & Raj Tandel

  2. Department of Gastroenterology, Smt. R. B. Shah Mahavir Super Speciality Hospital, Surat, 395 001, India

    Ritesh Prajapati, Rajiv Mehta, Mayank Kabrawala & Subhash Nandwani

  3. Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, 110 060, India

    Ashish Kumar

Authors
  1. Ritesh Prajapati
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  2. Rajiv Mehta
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  9. Ashish Kumar
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Contributions

Ritesh Prajapati: Study idea, concept and design, data extraction, interpretation of data, drafting of manuscript. Rajiv Mehta, Mayank Kabrawala, Subhash Nandwani: Study idea, concept and design, interpretation of data. Nisharg Patel, Mohit Sethia, Kamlesh Magnani, Raj Tandel: data extraction, interpretation of data, drafting of manuscript. Ashish Kumar: interpretation of data, drafting of manuscript.

Corresponding author

Correspondence to Ritesh Prajapati.

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Conflict of interest

RP, RM, MK, SN, NP, MS, KM, RT and AK state no competing interest.

Ethics statement

The study was performed conforming to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Ethical approval and Consent to participate

Approval from the institutional review board (4 November 2021, Surat Institute of Digestive Sciences Ethics Committee) was taken.

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The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

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Prajapati, R., Mehta, R., Kabrawala, M. et al. Dengue hepatitis: Incidence, spectrum and outcome. Indian J Gastroenterol 42, 355–360 (2023). https://doi.org/10.1007/s12664-023-01405-0

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