{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T10:00:54Z","timestamp":1788084054451,"version":"build-2784847793"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T00:00:00Z","timestamp":1578960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatitis infection from non\u2010hepatotropic viruses such as dengue virus (DENV) is increasing worldwide. There is increasing recognition of the changing epidemiology and atypical presentations of DENV infection including acute liver failure (ALF). There is paucity of data regarding incidence, disease characteristics, and markers of prognosis in patients who develop DENV\u2010related ALF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We aimed to study the incidence, clinical features, laboratory characteristics, and determinants of outcome in patients of DENV presenting with ALF. We reviewed all patients with DENV infection and focused on DENV\u2010related ALF from 2014 to 2017. Diagnosis of DENV and ALF was confirmed by serological tests and standard criteria, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six patients (20 men, mean age 32.3) developed ALF among 10\u00a0108 patients with DENV infection (0.35%). Twenty\u2010one patients died (58.3%). Although bilirubin, aspartate and alanine aminotransferase, and international normalized ratio were markedly elevated in all patients with DENV ALF, there was no statistically significant difference between survivors and non\u2010survivors. Lactate levels, pH at admission, and model for end\u2010stage liver disease (MELD) score were the only predictors of mortality. Lactate levels were significantly higher in non\u2010survivors (11.5\u00a0\u00b1\u00a04.2\u00a0mmol\/L) than survivors (6.3\u00a0\u00b1\u00a03.6\u00a0mmol\/L) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). MELD score in non\u2010survivors (26.7\u00a0\u00b1\u00a010.2) was significantly higher than in survivors (20\u00a0\u00b1\u00a07.2) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.039). Receiver operator characteristic curve showed lactate or pH to be a superior prognostic marker than MELD with an area under the curve of 0.80, 0.79, and 0.70, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dengue hepatitis progressed to ALF in 0.35%. Development of ALF was associated with a high mortality (&gt;\u00a050%). Lactate level, pH, and MELD score at admission were significant determinants of outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14927","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T09:39:31Z","timestamp":1574329171000},"page":"1223-1228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Dengue hepatitis with acute liver failure: Clinical, biochemical, histopathological characteristics and predictors of outcome"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3593-3746","authenticated-orcid":false,"given":"Harshad","family":"Devarbhavi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology St. John's Medical College Hospital  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Ganga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology St. John's Medical College Hospital  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology St. John's Medical College Hospital  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ksheetij","family":"Kothari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology St. John's Medical College Hospital  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajvir","family":"Singh","sequence":"additional","affiliation":[{"name":"Acute Care Surgery HGH, Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,14]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4461-x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature12060"},{"key":"e_1_2_5_4_1","volume-title":"Dengue: Guideline for Diagnosis, Treatment, Prevention and Control","author":"Organization WH","year":"2009"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702004000200006"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1992.47.265"},{"key":"e_1_2_5_7_1","first-page":"S220","article-title":"Serum lactate and lactate dehydrogenase as parameters for the prediction of dengue severity","volume":"97","author":"Sirikutt P","year":"2014","journal-title":"J. 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