High circulating levels of the dengue virus nonstructural protein NS1 early in dengue illness correlate with the development of dengue hemorrhagic fever

J Infect Dis. 2002 Oct 15;186(8):1165-8. doi: 10.1086/343813. Epub 2002 Sep 16.


Infection with any 1 of 4 dengue viruses produces a spectrum of clinical illness ranging from a mild undifferentiated febrile illness to dengue fever (DF) to dengue hemorrhagic fever (DHF), a potentially life-threatening disease. The morbidity and mortality of DHF can be reduced by early hospitalization and careful supportive care. To determine its usefulness as a predictor of DHF, plasma levels of the secreted dengue virus nonstructural protein NS1 (sNS1) were measured daily in 32 children with dengue-2 virus infections participating in a prospective, hospital-based study. Free sNS1 levels in plasma correlated with viremia levels and were higher in patients with DHF than in those with DF. An elevated free sNS1 level (> or =600 ng/mL) within 72 h of illness onset identified patients at risk for developing DHF.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Dengue Virus / immunology
  • Dengue Virus / isolation & purification*
  • Disease Progression
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Severe Dengue / blood
  • Severe Dengue / physiopathology*
  • Severe Dengue / virology*
  • Time Factors
  • Viral Nonstructural Proteins / blood*
  • Viremia / blood
  • Viremia / virology


  • NS1 protein, Dengue virus type 2
  • Viral Nonstructural Proteins