Evaluation of aminotransferase abnormality in dengue patients: A meta analysis

• Firstly evaluated the aminotransferase abnormality of dengue patients.
• 80% of DHF and 75% of DF patients showed AST elevation.
• 54% of DHF and 52% of DF patients presented with ALT elevation.
• AST/ALT level may be an indicator for severity of dengue infection.

Dengue virus is a type of flavivirus transmitted by Aedes mosquitoes. The symptoms of infection by this virus range from asymptomatic or mild symptomatic dengue fever (DF) to dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Significant abnormality in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) has been shown in a large number of dengue infection cases and to be indicator for liver injury provided that there are no other combined infections or liver injury. This study aims to assess the abnormal levels of liver aminotransferase in dengue patients. The related literature was searched in multiple databases, including PubMed, Embase, Google Scholar and Cochrane Library. The literature was selected through strict inclusion and exclusion criteria, and the quantitative synthesis of the liver aminotransferase abnormality was performed with R software. The fixed or random effects model was employed based on the results of the statistical test for homogeneity. In total, 15 studies were included. The proportion of AST abnormality with 95% confidence interval (95% CI) was 0.80 (95% CI: 0.56–0.92) in DHF patients and 0.75 (95% CI: 0.63–0.84) in DF patients; the proportion of ALT abnormality was 0.54 (95% CI: 0.34–0.73) in DHF patients and 0.52 (95% CI: 0.41–0.63) in DF patients. Serum ALT and AST levels may be indicators for evaluating liver injury in dengue infection and for diagnosis and treatment effect.

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