The impact of dengue haemorrhagic fever (DHF) on liver function was st
udied by measuring serum transaminase levels on 45 patients with DHF c
onfirmed by virus isolation and serodiagnosis in 1995. Abnormal levels
of AST and ALT were observed in 97.7 and 37.3% of the patients, respe
ctively, The fact that the level of AST was higher than that of ALT an
d that the elevation of transaminases was mild to moderate in most cas
es (<5-fold greater than the normal upper limit for AST and ALT) showe
d that liver involvement was also mild to moderate in most cases of DH
F. The results of transaminases did not differ significantly between c
ases with and without hepatitis B or hepatitis C virus infection, nor
between primary and secondary cases of infection, but a significantly
higher elevation of AST and ALT was observed in DHF patients with gast
rointestinal haemorrhage. Two patients with dengue encephalopathy (in
1992) and one patient with dengue encephalopathy who died of massive g
astrointestinal haemorrhage (in 1995) had unusually high transaminase
levels as a sign of acute liver failure. It is concluded that DHF may
cause mild to moderate liver dysfunction in most cases; only some pati
ents may suffer from acute liver failure leading to encephalopathy and
death.