Journal of Medical Virology 63:247±251 (2001) Activation of Coagulation and Fibrinolysis During Dengue Virus Infection

Dengue virus infection can induce mild dengue fever (DF) or severe dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS) in hu-man. The pathogenesis of hemorrhage in dengue virus infection is not fully understood. Since hemostasis depends on the balance between coagulation and ®brinolysis, alternation of some coagulation parameters (platelet count and acti-vated partial thromoboplastin time, APTT) as well as ®brinolytic parameters (tissue plasminogen activator, tPA and plasminogen activator inhibi-tor-1, PAI-1) were compared in 8 DHF/DSS and 17 DF patients. Patients showed thrombocytopenia, APTT prolongation, and tPA increase in the acute stage of disease, indicating activation of coagula-tion and ®brinolysis. The activation of coagula-tion and ®brinolysis in DHF/DSS patients was much more severe than DF patients. In the con-valescent stage, a rise of PAI-1 level and platelet count with concomitant decline of tPA level and APTT returned to normal in both DHF/DSS and DF patients. Therefore, the activation of coagulation and ®brinolysis during the acute stage of dengue virus infection is offset by the increase of platelet and PAI-1 during convalescent stage. Taken toge-ther, these results suggest that the degree of coagulation and ®brinolysis activation induced by dengue virus infection is associated with th