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Host biomarkers distinguish dengue from leptospirosis in Colombia: a case-control study.
Title | Host biomarkers distinguish dengue from leptospirosis in Colombia: a case-control study. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Conroy, AL, Gélvez, M, Hawkes, M, Rajwans, N, Liles, CW, Villar-Centeno, LA, Kain, KC |
Journal | BMC Infect Dis |
Volume | 14 |
Pagination | 35 |
Date Published | 2014 |
ISSN | 1471-2334 |
Abstract | BACKGROUND: Dengue fever and leptospirosis have partially overlapping geographic distributions, similar clinical presentations and potentially life-threatening complications but require different treatments. Distinguishing between these cosmopolitan emerging pathogens represents a diagnostic dilemma of global importance. We hypothesized that perturbations in host biomarkers can differentiate between individuals with dengue fever and leptospirosis during the acute phase of illness. METHODS: We randomly selected subjects from a prospective cohort study of acute febrile illness in Bucaramanga, Colombia and tested 19 serum biomarkers by ELISA in dengue fever (DF, n = 113) compared to subjects with leptospirosis (n = 47). Biomarkers were selected for further analysis if they had good discriminatory ability (area under the ROC curve (AUC) >0.80) and were beyond a reference range (assessed using local healthy controls). RESULTS: Nine biomarkers differed significantly between dengue fever and leptospirosis, with higher levels of Angptl3, IL-18BP, IP-10/CXCL10, Platelet Factor 4, sICAM-1, Factor D, sEng and sKDR in dengue and higher levels of sTie-2 in leptospirosis (p < 0.001 for all comparisons). Two biomarkers, sEng and IL18BP, showed excellent discriminatory ability (AUROC >0.90). When incorporated into multivariable models, sEng and IL18BP improved the diagnostic accuracy of clinical information alone. CONCLUSIONS: These results suggest that host biomarkers may have utility in differentiating between dengue and leptospirosis, clinically similar conditions of different etiology. |
DOI | 10.1186/1471-2334-14-35 |
Alternate Journal | BMC Infect. Dis. |
PubMed ID | 24444080 |