Dengue fever is widespread in all tropical and subtropical areas of the world and is the main public health problem posed by arboviroses. In Burkina Faso, an outbreak of dengue serotype “DENV-2”, which is responsible for severe forms of dengue, has been reported. In this study, we will discuss liver damage during this disease. The aim of this study was to describe the sociodemographic, diagnostic, therapeutic and evolutionary aspects of dengue patients with hepatic cytolysis. Patients and Methods: This was a prospective cross-sectional study of dengue disease in 2 facilities in the city of Ouagadougou. The study was spread over a period of 3 months from August to November 2019. The study population consisted of all patients hospitalised for dengue with a positive AgNS1 and/or IgM rapid diagnostic test (RDT) and presenting signs of liver damage. Results: During our study period we recruited 134 patients with dengue fever of which 93 or 69.4% had at least one elevated transaminase. The sex ratio was 1.90 and the average age was 35 years. Symptoms of liver damage were rare with right hypochondrial pain in 4.30% of cases and jaundice in 1.07% of cases. Dengue haemorrhagic fever was found in 5 patients. IgG was negative in 77.42%. The majority of patients (44% or 47.31%) had at least one transaminase value elevated to the upper limit of normal (ULN); and a minority, 14 patients or 15.06%, had transaminases above 10 ULN. A small proportion of patients had hepatocellular failure 26.92% with a lowered prothrombin level. Ninety-four per cent (94.62%) of the patients received analgesics. Level 1 analgesic (paracetamol) was the most widely administered, particularly in 76 patients (86.36%). More than half of the patients (57.14%) had a length of stay of less than or equal to 3 days and the outcome was favourable in 91.40%. Conclusion: Dengue virus causes alterations in the liver parenchyma. The degree of liver damage is variable. As clinical symptoms are almost non-existent, the measurement of transaminases remains important.
WHO. Dengue and Severe Dengue. https://www.who.int/fr/news-room/fact-sheets/detail/dengue-and-severe-dengue
Samantha, J. and Sharma, V. (2015) Dengue and Its Effects on Liver. World Journal of Clinical Cases, 3, 125-131. https://doi.org/10.12998/wjcc.v3.i2.125
Lewis, J., Mitra, A. and Chang, M. (2020) Acute Liver Failure in a Patient with Dengue Shock Syndrome. ACG Case Reports Journal, 7, 1-4. https://doi.org/10.14309/crj.0000000000000371
WHO (2016) Dengue in Burkina Faso, Outbreak Information Bulletin. https://reliefweb.int/report/burkina-faso/dengue-au-burkina-faso-bulletin-d-information-sur-les-flamb-es-pid-miques-18
Technical Report, after Action Review of the Dengue Epidemic in Burkina Faso. https://extranet.who.int/sph/sites/default/files/%28FR-Burkina%20Faso%29%20-%20RAA%20Dengue%202018.pdf
Ridde, V., Agier, I., Bonnet, E., Carabali, M., Dabiré, K.R., Fournet, F., Ly, A., Meda, I.B. and Parra, B. (2016) Presence of Three Dengue Serotypes in Ouagadougou (Burkina Faso): Research and Public Health Implications. Infectious Diseases of Poverty, 5, Article No. 23. https://doi.org/10.1186/s40249-016-0120-2
Sondo, A.K., Diendéré, E.A., Meda, B.I., et al. (2021) Severe Dengue in Adults and Children, Ouagadougou (Burkina Faso), West Africa, October 2015-January 2017. IJID Regions, 1, 53-59. https://doi.org/10.1016/j.ijregi.2021.09.010
Mamoudou, S. and Boushab, B.M. (2016) Hemorrhagic Form of Dengue Fever Observed at the Infectious Diseases Department CHU Yalgado Ouédraogo, Burkina Faso. The Pan African Medical Journal, 23, Article No. 168. https://doi.org/10.11604/pamj.2016.23.168.9234
Sondo, K.A., et al. (2022) Descriptive Study of Dengue Complications during the 2016 Outbreak in Ouagadougou, Burkina Faso. PAMJ—One Health, 7, 27.
Smith, D.R. and Khakpoor, A. (2009) Involvement of the Liver in Dengue Infections. WHO Regional Office for South-East Asia. Dengue Bulletin, 33, 75-86.
Itha, S., Kashyap, R., Krishnani, N., Saraswat, V.A., Choudhuri, G. and Aggarwal, R. (2005) Profile of Liver Involvement in Dengue Virus Infection. The National Medical Journal of India, 18, 127-130. https://doi.org/10.14309/00000434-200509001-00284
Faridi, M.M.A., Aggarwal, A., Kumar, M., et al. (2008) Clinical and Biochemical Profile of Dengue Haemorrhagic Fever in Children in Delhi. Tropical Doctor, 38, 28-30. https://doi.org/10.1258/td.2007.006158
Mohan, B., Patwari, A.K. and Anand, V.K. (2000) Hepatic Dysfunction in Childhood Dengue Infection. Journal of Tropical Pediatrics, 46, 40-43. https://doi.org/10.1093/tropej/46.1.40
Marianneau, P., Steffan, A.M., Royer, C., Drouet, M.T., Jaeck, D., Kirn, A. and Deubel, V. (1999) Infection of Primary Cultures of Human Kupffer Cells by Dengue Virus: No Viral Progeny Synthesis, But Cytokine Production Is Evident. Journal of Virology, 73, 5201-5206. https://doi.org/10.1128/JVI.73.6.5201-5206.1999
Seneviratne, S.L., Malavige, G.N. and de Silva, H.J. (2006) Pathogenesis of Liver Involvement during Dengue Viral Infections. Transactions of the Royal Society of Tropical Medicine and Hygiene, 100, 608-614. https://doi.org/10.1016/j.trstmh.2005.10.007
Guzman, M.G., Kouri, G.P., Bravo, J., Soler, M., Vazquez, S., Santos, M., et al. (1984) Dengue Haemorrhagic Fever in Cuba. II. Clinical Investigations. Transactions of the Royal Society of Tropical Medicine and Hygiene, 78, 239-241. https://doi.org/10.1016/0035-9203(84)90286-4
Chuang, Y.C., Lin, Y.S., Liu, H.S., Wang, J.R. and Yeh, T.M. (2013) Antibodies against Thrombin in Dengue Patients Contain Both Anti-Thrombotic and Profibrinolytic Activities. Thrombosis and Haemostasis, 110, 358-365. https://doi.org/10.1160/TH13-02-0149
Huy, N.T., Van Giang, T., Thuy, D.H.D., Kikuchi, M., Hien, T.T., Zamora, J., et al. (2013) Factors Associated with Dengue Shock Syndrome: A Systematic Review and Meta-Analysis. PLOS Neglected Tropical Diseases, 7, e2412. https://doi.org/10.1371/journal.pntd.0002412
Souza, L.J., Nogueira, R.M.R., Soares, L.C., Soares, C.E.C., Ribas, B.F., Alves, F.P., et al. (2007) The Impact of Dengue on Liver Function as Evaluated by Aminotransferase Levels. The Brazilian Journal of Infectious Diseases, 11, 407-410. https://doi.org/10.1590/S1413-86702007000400007
Monath, T.P. and Barrett, A.D. (2003) Pathogenesis and Pathophysiology of Yellow Fever. Advances in Virus Research, 60, 343-395. https://doi.org/10.1016/S0065-3527(03)60009-6
Kuo, C.H., Tai, D.I., Chang-Chien, C.S., et al. (1992) Liver Biochemical Tests and Dengue Fever. The American Journal of Tropical Medicine and Hygiene, 47, 265-270. https://doi.org/10.4269/ajtmh.1992.47.265
Chen, D.S., Locarnini, S. and Wallace, J. (2015) From the Big Three to the Big Four. The Lancet Infectious Diseases, 15, 626-627. https://doi.org/10.1016/S1473-3099(15)00026-2
Coulibaly, G., et al. (2019) Epidemiology of Acute Renal Failure during Dengue in the City of Ouagadougou. Néphrologie & Thérapeutique, 16, 27-32.
Bhatt, S., Gething, P.W., Brady, O.J., Messina, J.P., Farlow, A.W., Moyes, C.L., et al. (2013) The Global Distribution and Burden of Dengue. Nature, 496, 504-507. https://doi.org/10.1038/nature12060
Guzman, M.G., Halstead, S.B., Artsob, H., Buchy, P., Farrar, J., Gubler, D.J., et al. (2010) Dengue: A Continuing Global Threat. Nature Reviews Microbiology, 8, S7-S16. https://doi.org/10.1038/nrmicro2460
Karoli, R., Fatima, J., Siddiqi, Z., Kazmi, K.I. and Sultania, A.R. (2012) Clinical Profile of Dengue Infection at a Teaching Hospital in North India. The Journal of Infection in Developing Countries, 6, 551-554. https://doi.org/10.3855/jidc.2010
Parkash, O., Almas, A., Jafri, S.M., Hamid, S., Akhtar, J. and Alishah, H. (2010) Severity of Acute Hepatitis and Its Outcome in Patients with Dengue Fever in a Tertiary Care Hospital Karachi, Pakistan (South Asia). BMC Gastroenterology, 10, Article No. 43. https://doi.org/10.1186/1471-230X-10-43
Mallhi, T.H., Azreen, S.A., Amer, H.K., Azmi, S., Yusra, H.K. and Fauziah, J. (2015) Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: Retrospective Analysis. PLOS ONE, 10, e0138465. https://doi.org/10.1371/journal.pone.0138465
Tarnagda, Z., Cissé, A., Bicaba, B.W., et al. (2018) Dengue Fever in Burkina Faso, 2016. Emerging Infectious Diseases, 24, 170-172. https://doi.org/10.3201/eid2401.170973
Diallo, I., Sondo, K.A., Tieno, H., Tamelokpo, E.Y., Zoungrana, J., Sagna, Y., et al. (2017) à propos de 98 cas de dengue hospitalisés dans une clinique privée de Ouagadougou: Aspects épidémiologiques, diagnostiques et évolutifs. Bulletin de la Société de Pathologie Exotique, 110, 291-296. https://doi.org/10.1007/s13149-017-0585-7