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

NGUYEN THANH HUNGDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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NGUYEN TRONG LANDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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HUAN-YAO LEIDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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YEE-SHIN LINDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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LE BICH LIENDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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KAO-JEAN HUANGDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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CHIOU-FENG LINDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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DO QUANG HADepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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VU THI QUE HUONGDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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LAM THI MYDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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TRAI-MING YEHDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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JYH-HSIUNG HUANGDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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CHING-CHUAN LIUDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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SCOTT B. HALSTEADDepartment of Dengue Hemorrhagic Fever, Children’s Hospital No. 1, Ho Chi Minh City, Vietnam; Department of Microbiology and Immunology, Department of Medical Technology, and Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Arbovirus Laboratory, Pasteur Institute, Ho Chi Minh City, Vietnam; Department of Pediatrics, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Division of Research and Diagnosis, Center for Disease Control, Department of Health, Taipei, Taiwan, Republic of China; Uniformed Services University of the Health Sciences, Bethesda, Maryland

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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-γ and tumor necrosis factor-α) 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.

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