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Open AccessCommunication

Serum LPS Associated with Hantavirus and Dengue Disease Severity in Barbados

1
Faculty of Medical Sciences, University of the West Indies, Cave Hill, BB11000 St. Michael, Barbados
2
Epidemiology Research Unit, Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona Kingston 7, Jamaica
3
Best-dos Santos Public Health Laboratory, Enmore #6, Lower Collymore Rock, St. Michael BB11155, Barbados
*
Author to whom correspondence should be addressed.
Viruses 2019, 11(9), 838; https://doi.org/10.3390/v11090838
Received: 31 July 2019 / Revised: 4 September 2019 / Accepted: 5 September 2019 / Published: 9 September 2019
(This article belongs to the Special Issue Medical Advances in Viral Hemorrhagic Fever Research)
Hantavirus and dengue virus (DENV) infections are caused by RNA viruses which infect immune systems’ cells including monocytes, macrophages and dendritic cells and occur year-round in Barbados. A retrospective serological study (2008–2015) was conducted on hantavirus and dengue patient sera confirmed by IgM and IgG ELISA, NS1 and RT-PCR using Limulus amoebocyte lysate (LAL) kinetic turbidimetric method to determine serum endotoxin levels. Hantavirus patients were categorized into two groups, namely (a) hospitalized and (b) non-hospitalized. Dengue patients were categorized into 3 groups using 2009 WHO dengue guidelines (a) severe dengue (SD), (b) hospitalized non-severe dengue (non-SD) and (c) non-hospitalized non-SD. Statistical analyses were conducted to determine the association of endotoxin levels with hantavirus disease severity based on hospitalization and dengue disease severity. Serum endotoxin levels are associated with hantavirus disease severity and hospitalization and dengue disease severity (p < 0.01). Similar studies have found an association of serum endotoxin levels with dengue disease severity but never with hantavirus infection. Co-detection of hantavirus- and DENV-specific IgM in some patients were observed with elevated serum endotoxin levels. In addition, previous studies observed hantavirus replication in the gut of patients, gastrointestinal tract as a possible entry route of infection and evidence of microbial translocation and its impact on hantavirus disease severity. A significant correlation of serum endotoxin and hantavirus disease severity and hospitalization in hantavirus infected patients is reported for the first time ever. In addition, serum endotoxin levels correlated with dengue disease severity. This study adds further support to the role of endotoxin in both hantavirus and dengue virus infection and disease severity and its role as a possible therapeutic target for viral haemorrhagic fevers (VHFs). View Full-Text
Keywords: LPS; lipopolysaccharide; dengue; hantavirus; dengue fever; disease severity; HFRS; HPS; DENV; endotoxin; microbial translocation LPS; lipopolysaccharide; dengue; hantavirus; dengue fever; disease severity; HFRS; HPS; DENV; endotoxin; microbial translocation
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Douglas, K.O.; Samuels, T.A.; Gittens-St. Hilaire, M. Serum LPS Associated with Hantavirus and Dengue Disease Severity in Barbados. Viruses 2019, 11, 838.

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