The Association of Lipoprotein Changes and the Development of Plasma Leakage in Dengue Infection

There is interrelationship between infection and lipoprotein. This is a cohort prospective study which conducted November 2010 - February 2011. This study aimed to assess the changes of HDL-C, LDL-C, total cholesterol (TC), triglyceride (TG), in acute and critical phase of dengue infection and its association with plasma leakage. Subjects who had fever 48 hours or less and Dengue NS1 antigen test positive were admitted to Cipto Mangunkusumo Hospital Jakarta. We examined clinical and CBC daily; level of albumin, HDL-C, LDL-C, TC, TG; ultrasound to find ascites and pleural effusion. Among 51 subjects, 21 subjects (41%) had plasma leakage. There were significant lower of HDL-C, LDL-C, and higher TG in critical phase than acute phase. In critical phase, subjects with plasma leakage had a significant lower HDL-C level [26.3 (8.2) vs 33.1 (12.1) mg/dL, p=0.029] but not for LDL-C, TC, and TG. They also had a significantly higher reduction in HDL-C [19.6 (9.1) vs 11.5 (5.8) mg/dL, <0.0001] and TC [25.1 (20.0) vs 15.2 (14.5) mg/dL, 0.045] over the course of acute to critical phase. Lipoprotein changes during dengue infection were more pronounced among subjects who developed plasma leakage. The higher reduction in HDL-C is associated with the development of plasma leakage.