# Association of IL-18 and CXCL10 Levels with Disease Severity in Vietnamese Patients with Dengue Infection

## TL;DR

This study found that higher levels of IL-18 and CXCL10 in blood are linked to more severe dengue disease in Vietnamese patients.

## Contribution

The study identifies IL-18 and CXCL10 as potential biomarkers for predicting dengue severity in a Vietnamese population.

## Key findings

- Patients with severe dengue had significantly higher IL-18 and CXCL10 levels compared to those with non-severe dengue.
- Cut-off values of 669.65 pg/mL for IL-18 and 3739.5 pg/mL for CXCL10 were effective in distinguishing severe from non-severe dengue.
- Elevated liver enzymes and warning signs were more common in severe dengue cases.

## Abstract

Objectives: to investigate the association of IL-18 and CXCL10 levels with disease severity in Vietnamese patients infected with Dengue virus. Methods: A total of 295 serum samples were collected from patients with clinical presentation of Dengue virus infection during the 2022–2023 outbreaks in Hanoi, Vietnam. Clinical and laboratory parameters were recorded at the time of admission. IL-18 and CXCL-10 were measured by standard ELISA assays. The clinical outcome of Dengue infection was classified into three groups according to the WHO 2009 criteria. Results: Among the 295 patients, 140 were diagnosed with Dengue without warning signs, 134 with Dengue with warning signs, and 21 with severe Dengue according to the WHO 2009 criteria. Patients with SD had a greater proportion of warning signs than those with DwoWS and DwWS (bleeding: 57.1% versus 47.8% and 1.4%, p < 0.001) and (hepatomegaly: 23.8% versus 9.7% and 1.4%, p < 0.001). Higher levels of liver enzymes were observed in the SD group than in the DwoWS and DwWS groups (p < 0.001). Of note, elevated levels of IL-18 and CXCL-10 levels were found in the SD group compared to the DwoWS and DwWS groups (p < 0.01 and p = 0.037). Further ROC analysis revealed that the cut-off values for distinguishing severe Dengue from non-severe Dengue for IL-18 and CXCL-10 were both 669.65 pg/mL, whereas that of CXCL-10 was 3739.5 pg/mL. Conclusions: The present study showed that IL-18 and CXCL-10 are associated with Dengue severity. This finding suggests that IL-18 and CXCL-10 may be biomarkers for disease progression and disease severity in Dengue infection.