Sickle Cell Unit, Tropical Medicine Research Institute, University of the West Indies, Mona Kingston 7, Jamaica.
Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona Kingston 7, Jamaica.
EBioMedicine. 2015 Jul 6;2(8):937-41. doi: 10.1016/j.ebiom.2015.07.002. eCollection 2015 Aug.
Little is known about the significance of haemoglobin genotype in dengue fever severity. This study was undertaken to determine the case fatality ratio and the impact of genotype in patients with sickle cell disease and confirmed dengue fever.
This retrospective analysis included 40 patients with confirmed dengue and sickle cell disease, during the study period (2010-2012).
There was a significantly higher case fatality ratio, 12.5% among patients with either haemoglobin SC disease or homozygous SS disease when compared to that of the general population 0.41% (p < 0.0001). The unadjusted odds of dying among those with haemoglobin SC disease compared with the group with homozygous SS disease was OR = 4.4 (95% CI 0.6 to 31.7). The predictors of mortality independent of sickle cell disease genotype were haemoglobin concentration at presentation OR = 0.57 (95% CI, 0.35 to 0.94) and the change in haemoglobin concentration from steady state OR = 0.59 (95% CI, 0.37 to 0.94). Adjusting for haemoglobin concentration at presentation increased the risk of death for the SC genotype relative to SS genotype OR = 13.4 (95% CI 1.1 to 160.3).
The risk of fatal dengue may be higher among patients with a relatively mild genotype (haemoglobin SC).
关于血红蛋白基因型在登革热严重程度中的意义知之甚少。本研究旨在确定镰状细胞病和确诊登革热患者的病死率比和基因型的影响。
本回顾性分析包括在研究期间（2010-2012 年）的 40 例确诊为登革热和镰状细胞病的患者。
血红蛋白 SC 疾病或纯合子 SS 疾病患者的病死率比普通人群（0.41%）高得多，为 12.5%（p<0.0001）。血红蛋白 SC 疾病患者与纯合子 SS 疾病患者相比，死亡的未调整比值比为 OR=4.4（95%CI 0.6 至 31.7）。独立于镰状细胞病基因型的死亡预测因素为就诊时的血红蛋白浓度 OR=0.57（95%CI，0.35 至 0.94）和从稳定状态开始的血红蛋白浓度变化 OR=0.59（95%CI，0.37 至 0.94）。调整就诊时的血红蛋白浓度后，与 SS 基因型相比，SC 基因型的死亡风险增加 OR=13.4（95%CI 1.1 至 160.3）。
在相对轻度基因型（血红蛋白 SC）的患者中，致命性登革热的风险可能更高。
