Determination of Viremia and Concentration of Circulating Nonstructural Protein 1 in Patients Infected with Dengue Virus in Mexico

Sergio I. de la Cruz-Hernández Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Hilario Flores-Aguilar Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Silvia González-Mateos Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Irma López-Martinez Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Celia Alpuche-Aranda Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Juan E. Ludert Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Rosa M. del Angel Departament of Virology, Department of Immunology and Immunogenetics, and Dirección General Adjunta, Instituto de Diagnóstico y Referencia Epimiológicos, and Departament of Infectomics and Molecular Pathogenesis, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico

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Higher levels of viremia and circulating nonstructural protein 1 (NS1) have been associated with dengue disease severity. In this study, viremia and circulating NS1 levels were determined in 225 serum samples collected from patients in Mexico infected with dengue virus serotypes 1 and 2 (DENV-1 and DENV-2). Patients with dengue hemorrhagic fever (DHF) who were infected with DENV-1 showed higher levels of circulating NS1 than patients with dengue fever (DF) (P = 0.0175). Moreover, NS1 levels were higher in patients with primary infections with DENV-1 than in patient infected with DENV-2 (P < 0.0001) and in patients with primary infections with DENV-2 than in patients with secondary infections with DENV-2 (P = 0.0051). Unexpectedly, viremia levels were higher in patients with DF than in those with DHF infected with either DENV-1 or DENV-2 (P = 0.0019 and P = 0.001, respectively) and in patients with primary infections than those with secondary DENV-2 infections (P < 0.0001). Results indicate that levels of circulating NS1 vary according to the infecting serotype, immunologic status (primary or secondary infection), and dengue disease severity.

Author Notes

* Address correspondence to Juan E. Ludert and Rosa M. del Angel, Departamento de Infectómica y PatogÉnesis Molecular, Centro de Investigación y Estudios Avanzados del Instituto PolitÉcnico Nacional, Av. IPN 2508, Colonia San Pedro Zacatenco, Mexico City DF 07360, Mexico, E-mails: jludert@cinvestav.mx and rmangel@cinvestav.mx

Financial support: This study was partially supported by grant 112118 from Consejo Nacional de Ciencia y Tecnología, Mexico and grant 248 from Instituto de Ciencia y Techlogía-D.F., Mexico. The PLATELIA™ Dengue NS1 Antigen Assays and the PanBio ELISAs used in this study were kindly donated by Bio-Rad Laboratories and CTR Scientific, Mexico, respectively.

Authors' addresses: Sergio I. de la Cruz-Hernández, Hilario Flores-Aguilar, Silvia González-Mateos, Irma López-Martinez, and Celia Alpuche-Aranda, Instituto de Diagnostico y Referencia Epidemiológicos, Prolongación Carpio No. 470, Colonia Santo Tomás, Delegación Miguel Hidalgo, CP 11340, Mexico City DF, Mexico, E-mails: sidlch@yahoo.com.mx, hilario.flores@salud.gob.mx, sigomateos@yahoo.com, lopezmi74@gmail.com, and celia.alpuche@salud.gob.mx. Juan E. Ludert and Rosa M. del Angel, Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Av. IPN 2508, Colonia San Pedro Zacatenco, Mexico City DF 07360, Mexico, E-mails: jludert@cinvestav.mx and rmangel@cinvestav.mx.

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