Prospective Evaluation of Hepatic Dysfunction in Patients with Dengue Fever: A Clinical and Biochemical Outcome Study

Abstract

Background: Dengue fever is a rapidly emerging mosquito-borne viral illness with a wide clinical spectrum ranging from mild febrile disease to severe life-threatening complications. Hepatic dysfunction is increasingly recognized as a significant systemic manifestation of dengue infection and may serve as an early predictor of disease severity and adverse clinical outcomes. However, prospective data from eastern India, particularly Bihar, remain limited.
Aim: To prospectively evaluate the clinical profile and biochemical pattern of hepatic dysfunction in patients with dengue fever and determine its association with disease severity and clinical outcomes in a tertiary care center in Bihar.
Methodology: This prospective observational study included 120 adult patients with laboratory-confirmed dengue infection selected randomly from those presenting to the outpatient department over a six-month period. Detailed clinical evaluation and laboratory investigations, including liver function tests (AST, ALT, bilirubin, albumin, and coagulation profile) were performed. Hepatic dysfunction was assessed and correlated with the WHO dengue severity classification and clinical outcomes. Statistical analysis was performed using SPSS version 20.0, with p < 0.05 considered significant.
Results: Elevated AST and ALT were observed in 85% and 78.3% of patients, respectively, with AST levels exceeding ALT. Hyperbilirubinemia and hypoalbuminemia were noted in 22.5 and 28.3% of cases. Significant association was found between hepatic dysfunction and severity of dengue (p < 0.05). Patients with severe dengue had markedly elevated transaminases, longer hospital stay, and higher ICU admission rates. Mortality was observed in 1.7% of cases, all associated with severe hepatic involvement.
Conclusion: Hepatic dysfunction is highly prevalent in dengue fever and strongly correlates with disease severity and outcomes. Routine liver function assessment is a valuable, cost-effective prognostic tool for early identification of high-risk patients in tertiary care settings.