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ASSOCIATION BETWEEN SEX, NUTRITIONAL STATUS, SEVERITY OF DENGUE HEMORRHAGIC FEVER, AND IMMUNE STATUS IN INFANTS WITH DENGUE HEMORRHAGIC FEVER

The association between sex, nutritional status, and the severity of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), and immune status was investigated in 245 Vietnamese infants with predominantly primary infections with dengue virus. Male and female infants were at equal risk of developing DHF/DSS. However, infants of low height and weight for age were under-represented among DHF/DSS cases compared with 533 healthy baby clinic infant controls. Acute illness phase blood levels of selected cytokines (interferon- and tumor necrosis factor-) and serum levels of antibodies to dengue virus were elevated in the same range in male and female infants with DHF/DSS, as well as in infants with and without malnutrition.

Received September 18, 2004. Accepted for publication November 18, 2004.

Acknowledgments: We thank Dr. Tran Tan Tram (Children’s Hospital No. 1, Ho Chi Minh City, Vietnam) and Dr. Chung-Ming Chang (National Health Research Institutes, Taipei, Taiwan) for help and support during the course of this study. We also thank Dr. Hoang Le Phuc for help with data analyses, and the doctors and nurses of the Department of Dengue Hemorrhagic Fever, Children’s Hospital No. 1-Ho Chi Minh City for providing excellent patient care.

Financial support: This work was partially supported by grant NHRI-CN-CL9303P from the National Health Research Institutes (Taiwan).

Disclosure: None of the authors have commercial or other associations that might pose a conflict of interest.

Authors’ addresses: Nguyen Thanh Hung, Nguyen Trong Lan, Department of Dengue Hemorrhagic Fever, Children’s Hospital No.1, 341 Su Van Hanh Street, District 10, Ho Chi Minh City, Vietnam, Telephone: 84-8- 927-1119 or 84-8- 927-1156, Fax: 84-8-927-0053, E-mail: hungdhf{at}hcm.fpt.vn. Huan Yao-Lei, Yee-Shin Lin, Le Bich Lien, Kao-Jean Huang, and Chiou-Feng Lin, Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China. Do Quang Ha and Vu Thi Que Huong, Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam. Lam Thi My, Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Trai-Ming Yeh, Department of Medical Technology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China. Jyh-Hsiung Huang, Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China. Scott B. Halstead, Uniformed Services University of the Health Sciences, Bethesda, MD 20815, E-mail: halsteads{at}erols.com.

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