Kinetics of CD4+ T-Lymphocyte in Dengue Virus Infection

Abstract

Cellular immunity plays an important role in viral infection. The activation of effector T-lymphocytes and the release of cytokines define the course of dengue viral infection. CD4⁺ T-lymphocyte induces the immunopathology via various mechanisms; however,  its kinetics in different onset of fever and disease severity are not fully understood. This study was conducted to observe the kinetics of CD4⁺ T-lymphocyte level among dengue infected patients and to obtain the absolute cell count and relative percentage of CD4⁺ T-lymphocyte. This was a descriptive study on thirty six patients who met the WHO-1997 criteria of dengue infection, hospitalized in Dr. Sardjito Hospital in the period of March to May 2009. The CD4⁺ T-lymphocytes were examined using the flow cytometer. The significance of median CD4⁺ T-lymphocytes among days were assessed using Kruskal-Wallis and Mann-Whitney SPSS 11 for Window. The absolute CD4⁺ T-lymphocyte was significantly different among days (p<0.05) between DF and DHF patients, while the relative CD4⁺ percentage count was not  different (p>0.05).  The Absolute CD4+ T-lymphocytes count was low in the beginning of the disease course and increased from the 2nd day of fever to the normal level on the 7^th day. In conclusion, DF and DHF do not differ in the absolute CD4⁺ T-lymphocytes count as well as in the relative CD4+ T-lymphocytes percentage.

Key words: CD4+ T-lymphocyte, dengue fever, dengue hemorrhagic fever, dengue virus


Kinetik Limfosit T CD4+ pada infeksi Virus Dengue


Abstrak

Imunitas seluler berperan penting dalam infeksi virus. Aktivasi efektor limfosit T dan terlepasnya sitokin merupakan gambaran utama perjalanan klinis infeksi virus dengue. Sel limfosit T CD4+ menginduksi imunopatologi melalui berbagai mekanisme, namun bagaimana kinetikanya pada hari demam yang berbeda dan derajat berat penyakit masih belum sepenuhnya dipahami. Penelitian ini bertujuan untuk mengamati kinetika sel limfosit T CD4+ pada pasien infeksi dengue dan mendapatkan kadar absolut serta persentase relatif limfosit T CD4+. Penelitian deskriptif ini mengikutsertakan tiga puluh enam pasien yang memenuhi kriteria WHO 1997 untuk infeksi dengue, dirawat di RSUP Dr. Sardjito antara Maret sampai Mei 2009. Kadar limfosit T CD4+ diperiksa menggunakan flow cytometer. Perbedaan median limfosit T CD4+ pada berbagai hari demam dianalisis menggunakan Uji Kruskal-Wallis dan Mann-Whitney SPSS 11 untuk Windows. Kadar absolut limfosit T CD4+ berbeda secara bermakna antara hari demam (p<0,05). Persentase relatif limfosit T CD4+ tidak berbeda bermakna antara demam dengue dan demam berdarah dengue (p>0,05). Kadar absolut limfosit T CD4+ rendah pada awal perjalanan penyakit, meningkat pada hari ke-2 demam dan mencapai nilai normal pada hari ke-7 demam. Demam dengue dan demam berdarah dengue tidak menunjukkan kadar absolut maupun persentase relatif limfosit T CD4+ yang berbeda bermakna.

Kata kunci: Demam berdarah dengue, demam dengue, limfosit T CD4+, virus dengue

DOI: 10.15395/mkb.v46n4.341