Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Department of Multidisciplinary Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Sri Lanka.
Epidemiol Infect. 2020 Jun 29;148:e119. doi: 10.1017/S0950268820000229.
Circulation of multiple dengue virus (DENV) serotypes in a locale has resulted in individuals becoming infected with mixed serotypes. This research was undertaken to study the clinical presentation, presence of DENV serotypes and serological characteristics of DENV infected patients with co-infections from three Provinces of Sri Lanka where DENV-1 and -2 predominated during the study. A reverse transcription polymerase chain reaction was performed on 1249 patient samples and 301 were positive for DENV (24.1%). DENV-1 was the predominant serotype detected in 137 (45.51%) followed by DENV-2 in 65 (21.59%), DENV-3 in 59 (19.6%) and DENV-4 in 4 (1.32%) patients with mono-infections. Thirty-three patients (10.96%) had DENV co-infections with two or more serotypes. The highest number of co-infections was noted between DENV-1 and DENV-2 (57.57%) suggesting co-infection is driven by the frequency of the circulating serotypes. Platelet counts were significantly higher in DENV co-infected patients although clinical disease severity or white blood cell count, packed cell volume or viraemia were not significantly different in the co-infected compared to the mono-infected patients. Thus co-infection with multiple DENV serotypes does occur but with the exception of improved platelet counts in co-infected patients, there is no evidence that clinical or laboratory measures of disease are altered.
在一个地区，多种登革热病毒（DENV）血清型的循环导致个体感染了混合血清型。本研究旨在研究来自斯里兰卡三个省份的登革热感染患者的临床特征、DENV 血清型存在情况和血清学特征，这些省份在研究期间以 DENV-1 和 DENV-2 为主。对 1249 份患者样本进行了逆转录聚合酶链反应，其中 301 份为登革热阳性（24.1%）。检测到的主要血清型是 DENV-1，有 137 例（45.51%），其次是 DENV-2，有 65 例（21.59%），DENV-3，有 59 例（19.6%），DENV-4，有 4 例（1.32%），均为单感染。33 例（10.96%）患者存在两种或多种血清型的 DENV 合并感染。DENV-1 和 DENV-2 之间的合并感染数量最多（57.57%），这表明合并感染是由循环血清型的频率驱动的。尽管在合并感染患者中血小板计数显著升高，但与单感染患者相比，临床疾病严重程度或白细胞计数、红细胞压积或病毒血症并无显著差异。因此，确实会发生多种 DENV 血清型的合并感染，但除了合并感染患者的血小板计数改善外，没有证据表明临床或实验室疾病指标发生改变。
