{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T13:10:14Z","timestamp":1779369014843,"version":"3.53.0"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Severe dengue is influenced by the virus serotype, viral load, host exposure status, immune response, host genetics, and other host factors. The objective of the present study was to identify a panel of prognostic markers for severe dengue during the viraemic phase. We investigated 326 real\u2010time RT\u2010PCR positive dengue cases to find out the association of viral load, antibody titers, and immune status. Plasma levels of 27 cytokines, chemokines, and endothelial cell\u2010related factors were estimated in a subset of 206 patients. Viral load was lower in DENV\u20103 cases compared to DENV\u20101 and DENV\u20102 cases (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Viral load was lower in secondary infections compared to primary infections, irrespective of serotypes (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Viral load was not different between dengue patients without warning signs (DWOWS), dengue with warning signs (DWWS), and severe dengue. The total number of cytokines, chemokines, and growth factors produced above the assay detection threshold was higher in severe cases compared to DWOWS and DWWS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Penalized multivariate regression identified significant associations between dengue serotype and IgM OD ratio, viral load (log\u2081\u2080), granulocyte colony\u2010stimulating factor, interferon (IFN)\u2010\u03b3 induced protein\u201010 (IP\u201010), and macrophage inflammatory protein\u20101\u03b2 (MIP\u20101\u03b2) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), with good discrimination between DENV\u20101 and DENV\u20102 infections (area under the curve [AUC]\u2009=\u200981.11%). IgA OD ratio, viral load (log\u2081\u2080), interleukin\u201010 (IL\u201010), MIP\u20101\u03b1, syndecan\u20101 (SDC\u20101), and vascular endothelial growth factor\u2010A were significantly associated with immune status, accurately distinguishing primary and secondary infections (AUC\u2009=\u200992.56%). IFN\u2010\u03b3, IL\u20101\u03b2, IL\u20101RA, IL\u20102, IL\u20106, IL\u20108, IL\u201010, IL\u201018, and TPO were significantly elevated in severe dengue cases compared to DWOWS and DWWS (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Exploratory penalized regression results suggested higher odds of the dengue severity with increasing levels of IgA, IgE, G\u2010CSF, GM\u2010CSF, IFN\u2010\u03b1, IFN\u2010\u03b3, IL\u20101\u03b2, IL\u20101RA, IL\u20102, IL\u20104, IL\u20106, IL\u20108, IL\u201010, IL\u201012p70, IL\u201017A, IL\u201018, IP\u201010, MCP\u20101, resistin, SDC\u20101, TNF\u2010\u03b1, and VEGF\u2010D (OR\u2009&gt;\u20091 per standard deviation increase). To conclude, the present study suggests that a dysregulated immune response, indicated by elevated levels of cytokines, chemokines, and endothelial cell\u2010related factors, occurs in the viraemic phase of severe dengue cases and can be exploited to design a panel of prognostic markers.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70882","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:26:45Z","timestamp":1774610805000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Viraemic Phase Viral Load, Antibody Responses, and Immune Biomarkers With Severe Dengue"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-8589","authenticated-orcid":false,"given":"Kalichamy","family":"Alagarasu","sequence":"first","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"},{"name":"Savitribai Phule Pune University, Ganeshkhind Pune India"},{"name":"Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh K.","family":"Gurav","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"},{"name":"Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Pulinchani","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"},{"name":"Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupali","family":"Bachal","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradnya","family":"Bhadale","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aishwarya","family":"Telmore","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"},{"name":"Savitribai Phule Pune University, Ganeshkhind Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahadeo","family":"Kakade","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susmit","family":"Sambhare","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratiksha","family":"Sonare","sequence":"additional","affiliation":[{"name":"ICMR\u2013National Institute of Virology Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasant","family":"Nagvekar","sequence":"additional","affiliation":[{"name":"Lilavati Hospital Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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