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Journal of Clinical Microbiology, December 2001, p. 4332-4338, Vol. 39, No. 12
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.12.4332-4338.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Kinetics of Dengue Virus-Specific Serum Immunoglobulin Classes and Subclasses Correlate with Clinical Outcome of Infection

P. Koraka,1 C. Suharti,2 T. E. Setiati,2 A. T. A. Mairuhu,3 E. Van Gorp,3 C. E. Hack,4 M. Juffrie,5 J. Sutaryo,5 G. M. Van Der Meer,6 J. Groen,1,* and A. D. M. E. Osterhaus1

Laboratory for Exotic Viral Infections, Institute of Virology, Erasmus Medical Centre Rotterdam, Rotterdam,1 and Department of Internal Medicine Slotervaart Hospital,3 Central Laboratory of The Netherlands Red Cross Blood Transfusion Service and Department of Clinical Chemistry, 4 and Department of Pediatrics,6 Academic Hospital Free University, Amsterdam, The Netherlands, and Department of Internal Medicine and Paediatric Department, University of Diponegoro, Semarang,2 and Department of Paediatrics, Faculty of Medicine, Gadjah Mada University, Yogyakarta,5 Indonesia

Received 11 April 2001/Returned for modification 27 May 2001/Accepted 21 September 2001

The kinetics of dengue virus (DEN)-specific serum immunoglobulin classes (immunoglobulin M [IgM] and IgA) and subclasses (IgG1 to IgG4) were studied in patients suffering from dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). Serum samples from non-DEN febrile patients were included as controls. IgM, IgG1, and IgG3 serum antibodies were the predominant immunoglobulins throughout the course of illness in all three patient groups. In contrast, IgA antibodies were significantly higher in the acute phase in DSS patients compared to those in DF patients (P < 0.05). The levels of IgG1 differed significantly between patients with DF and those with DHF and DSS (P < 0.05). A significant difference was also found in IgG3 levels between DF patients and DHF patients (P < 0.05) but not between DF patients and DSS patients. Finally, levels of IgG4 antibodies differed significantly between DF patients and DSS patients (P < 0.05). Collectively, these data show that increased levels of DEN-specific IgA, IgG1, and IgG4 serum antibodies are risk markers for the development of DHF and DSS and that their measurement may provide valuable guidance for early therapeutic intervention.

* Corresponding author. Mailing address: Laboratory for Exotic Viral Infections, Department of Virology, Erasmus Medical Centre Rotterdam, Dr. Molenwaterplein 40, 3015GD Rotterdam, The Netherlands. Phone: 31(0) 104635428. Fax: 31(0) 104633441. E-mail: groen{at}viro.fgg.eur.nl.

Journal of Clinical Microbiology, December 2001, p. 4332-4338, Vol. 39, No. 12
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.12.4332-4338.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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