Influence of Dengue Fever on Liver Function as Indicated by Aminotransferase Levels

Abstract

Background: Dengue fever is a globally prevalent arboviral infection with varied clinical manifestations. Liver involvement is increasingly recognized as a common complication, but its relationship with disease severity remains incompletely understood. This study aimed to evaluate the influence of dengue virus infection on liver function as indicated by aminotransferase levels and to assess their potential as predictors of disease severity.

Materials and Methods: This cross-sectional observational study included 100 serologically confirmed dengue patients admitted to Enam medical college hospital. Patients were classified as having dengue fever (DF) or dengue hemorrhagic fever (DHF) according to WHO criteria. Comprehensive clinical assessment and serial laboratory investigations, including liver function tests, were performed. The severity of liver involvement was classified based on aminotransferase levels: Grade A (normal), Grade B (>1-3× upper limit of normal [ULN]), Grade C (>3-10× ULN), and Grade D (>10× ULN).

Results: Out of 100 patients, 54% were male and the average age was 36.7 ± 15.2 years. Among them, 72 had dengue fever (DF) and 28 had dengue hemorrhagic fever (DHF). Liver involvement, indicated by elevated aminotransferase levels, was observed in 85% of patients. The median AST and ALT levels were significantly higher in DHF compared to DF patients (AST: 286 vs. 98 IU/L, p<0.001; ALT: 198 vs. 68 IU/L, p<0.001). AST levels exceeded ALT in 87% of cases, with a mean AST/ALT ratio of 1.7±0.6. Severe liver involvement (Grade D) was significantly more common in DHF than DF patients (28.6% vs. 5.6%, p<0.001). The frequency of complications increased significantly with the severity of liver involvement, from 0% in Grade A to 58.3% in Grade D (p<0.001). All patients with elevated aminotransferases showed normalization within 4 weeks without specific hepatoprotective therapy.

Conclusion: Liver involvement is a common feature of dengue infection, with a distinctive pattern of AST predominance. The severity of liver involvement correlates significantly with disease severity and clinical outcomes. Despite significant elevations, hepatic involvement in dengue is generally self-limiting. Routine assessment of aminotransferase levels should be considered in the management of dengue patients to identify those at risk of developing severe diseases.

Eastern Med Coll J. July 2025; 10 (2): 102-110