A prevalence study of infections by different serotypes and genotypes of dengue virus in different blood and body fluid compartments of acutely-infected individual patient

Abstract

In this present research, we performed a prevalence study of infections by different serotypes and genotypes of dengue virus (DENV) in different blood and body fluid compartments of acutely-individual patients by using nested reverse transcription-polymerase chain reaction (nested RT-PCR) and sequencing. 95 dengue patients were enrolled and confirmed by standard criteria of enzyme-linked Immunosorbent Assay (ELISA) and nested RT-PCR. All specimens from all dengue patients were serotype by using multiplex RT-PCR. We detected serotypes of dengue virus from 85 of 95 patients. We found both single and multiple infections. We found dengue serotype 1 (DEN-1) at 24.61% (16 of 85), serotypes 2 (DEN-2) at 9.23% (6 of 85), serotypes 3 (DEN-3) at 16.93% (11 of 85), and serotype 4 (DEN-4) at 49.23% (32 of 85). Moreover, 23.53% or 20 of 85 patients were multiple infections, a proportion that is more than previously reported. We found the rate of double infections with DEN-1 and DEN-4 at 25% (5 of 20), which was the same as those of DEN-2 and DEN-4. DEN-1 with DEN-2 was 10% (2 of 20), DEN-2 with DEN-3 15% (2 of 20), and DEN-1 with DEN-3 8.7% (2 of 23). In addition, we also detected multiple infections with 3 serotypes of dengue virus. We found that triple infections with DEN-1, DEN-2, and DEN-4 were 10% (2 of 23), and also one patient with DEN-1, DEN-3, and DEN-4. Next, all specimens were genotyped by DNA sequencing. We found that single-serotype dengue isolates from several compartments of an acutely-infected individual patient on the same day are of a single genotype and strain. Isolates from the following days, however, demonstrated selected mutations. A correlation between single or multi-serotype infections and clinical severity cannot be demonstrated from the present study.