Association Between Anti-Dengue IgM/IgG Serological Profile Results and the Severity of Dengue Infection
Abstract
Background: Dengue infection is a disease caused by the Dengue virus, which is transmitted by Aedes mosquito vectors and can cause Dengue fever (DF) and even Dengue shock syndrome (DSS).
Objective: The aim of this study was to determine the relationship between serological profiles and the severity of Dengue.
Methods: Variations in IgM and IgG serological profiles distinguish between primary infection (predominantly increased IgM) and secondary infection (decreased IgM and rapid increase in IgG), which are associated with differences in clinical manifestations and the severity of Dengue infection. This retrospective analytical descriptive study was conducted at KRMT Wongsonegoro Hospital with 160 dengue patient samples (period 2021-2022) selected by simple random sampling, followed by data analysis using the Chi-Square and Fisher Exact tests.
Results: The results showed a significant association between anti-Dengue serological tests and severity, with IgM (+), IgG (+), and the combination of IgM (+) IgG (+) each having a p-value <0.05. Patients with IgM (+) had a 4 times higher risk of severe dengue, while IgG (+) increased the risk up to 7 times, and the combination of IgM (+) IgG (+) increased the risk 5 times.
Conclusion: These results confirm that serological profiles can serve as early predictive indicators of severity, thereby supporting early triage and appropriate treatment for high-risk patients.
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References
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2. Kementrian Kesehatan RI. Pedoman Nasional Pelayanan Kedokteran Tatalaksana Infeksi Dengue pada Dewasa. Jakarta: Kementrian Kesehatan;2020
3. Riskia Tristianti V, Manurung J, Theodosia R, Beyeng D. Karakteristik infeksi virus dengue di RSUD Lewoleba Kabupaten Lembata pada periode Januari 2019 – Desember 2021. Intisari Sains Medis. 2022;13(2):500-506. doi:10.15562/ISM.V13I2.1420
4. Wellekens K, Betrains A, De Munter P, Peetermans W. Dengue: current state one year before WHO 2010–2020 goals. Acta Clinica Belgica. 2020. doi:10.1080/17843286.2020.1837576
5. Maula AW, Fuad A, Utarini A. Ten-years trend of dengue research in Indonesia and South-east Asian countries: a bibliometric analysis. Glob Health Action. 2018;11(1). doi:10.1080/16549716.2018.1504398
6. World Health Organization. Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever: World Health Organization; 2012
7. ASEAN Biodiaspora Virtual Center. Morbidity and Mortality Weekly Report: Infectious & Emerging Diseases. [Internet].Accessed February 19, 2026. https://www.moh.gov.sg/resources-statistics/infectious-disease-statistics/2023/weekly-infectious-diseases-bulletin
8. Kementrian Kesehatan RI. Profil Kesehatan Indonesia 2021. Jakarta: Kementrian Kesehatan. 2022.
9. Priesley F, Reza M, Rusdji SR. Hubungan Perilaku Pemberantasan Sarang Nyamuk dengan Menutup, Menguras dan Mendaur Ulang Plus (PSN M Plus) terhadap Kejadian Demam Berdarah Dengue (DBD) di Kelurahan Andalas. Jurnal Kesehatan Andalas. 2018;7(1):124. doi:10.25077/JKA.V7.I1.P124-130.2018
10. Putu D, Indriyani R, Gustawan W. Manifestasi klinis dan penanganan demam berdarah dengue grade 1: sebuah tinjauan pustaka. Intisari Sains Medis. 2020;11(3):1015-1019. doi:10.15562/ISM.V11I3.847
11. Bhatt P, Sabeena SP, Varma M, Arunkumar G. Current Understanding of the Pathogenesis of Dengue Virus Infection. Curr Microbiol. 2021;78(1):17. doi:10.1007/S00284-020-02284-W
12. Saeed O, Asif A. Dengue virus disease; the origins. Dengue Virus Disease: From Origin to Outbreak. 2020:9-16. doi:10.1016/B978-0-12-818270-3.00002-3
13. Harapan H, Michie A, Mudatsir M, Sasmono RT, Imrie A. Epidemiology of dengue hemorrhagic fever in Indonesia: analysis of five decades data from the National Disease Surveillance. BMC Res Notes. 2019;12(1). doi:10.1186/S13104-019-4379-9
14. Candra A. Asupan Gizi dan Penyakit Demam Berdarah/ Dengue Hemoragic Fever (DHF). Journal of Nutrition and Health. 2019. doi:10.14710/JNH.7.2.2019.23-31
15. Pan P, Zhang Q, Liu W, et al. Dengue Virus Infection Activates Interleukin-1β to Induce Tissue Injury and Vascular Leakage. Front Microbiol. 2019;10:481385. doi:10.3389/FMICB.2019.02637/BIBTEX
16. Guzman MG, Fuentes O, Martinez E, Perez AB. Dengue. International Encyclopedia of Public Health. 2017:233-257. doi:10.1016/B978-0-12-803678-5.00103-X
17. Zulhaidah Arthamin M, Dharma R, et al. Analysis of Dengue Specific Immune Respone Based on Serotype, Type and Severity of Dengue Infection. Indonesian Journal of Clinical Pathology and Medical Laboratory. 2017;23(3):230-233. doi:10.24293/IJCPML.V23I3.1199
18. Ulandari P, Latuconsina VZ, Rahawarin H. Hubungan Imunoglobulin M (IgM) dan Imunoglobulin G (IgG) Dengan Derajat Keparahan Infeksi Dengue di RSUD Dr. M. Haulussy dan RS Sumber Hidup Ambon Periode 2018. PAMERI: Pattimura Medical Review. 2020;2(1):1-12. doi:10.30598/PAMERIVOL2ISSUE1PAGE1-12
19. Alifah N. Titer IgG & Rasio IgM / IgG Anti Dengue Terhadap Indeks Efusi Pleura dan Derajat Klinis Demam Berdarah Dengue. Jurnal Media Analis Kesehatan. 2004.
20. Nagar PK, Savargaonkar D, Anvikar AR. Detection of Dengue Virus-Specific IgM and IgG Antibodies through Peptide Sequences of Envelope and NS1 Proteins for Serological Identification. J Immunol Res. 2020;2020. doi:10.1155/2020/1820325
21. Inderjit S, Sudarmaja IM, Swastika IK. Clinical characteristic of dengue fever and dengue hemorrhagic fever among patients at Sanglah Hospital, Denpasar, Bali. Intisari Sains Medis. 2021;12(3):974-977. doi:10.15562/ISM.V12I3.550
22. Ren ZZ, Zheng Y, Sun T, Wang GY, Chen XM, Zhou YM. A survey of clinical and laboratory characteristics of the dengue fever epidemic from 2017 to 2019 in Zhejiang, China. Medicine. 2022;101(42):E31143. doi:10.1097/MD.0000000000031143
23. Putra IMBW, Hartawan INB, Gustawan IW. Karakteristik infeksi virus dengue pada pasien anak di poliklinik anak Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar tahun 2016. Intisari Sains Medis. 2020;11(1):28-34. doi:10.15562/ISM.V11I1.521
24. Badan Pusat Statistik. Banyak Curah Hujan dan Hari Hujan Menurut Bulan di Provinsi Jawa Tengah, 2019 - 2021. [Internet]. [dikutip 19 Oktober 2023]. Available from : https://jateng.bps.go.id/id
25. Jing Q, Wang M. Dengue epidemiology. Global Health Journal. 2019;3(2):37-45. doi:10.1016/J.GLOHJ.2019.06.002
26. Dinas Kesehatan Kota Semarang. Dashboard Kesehatan . 2019. Accessed October 15, 2023. Available from : http://119.2.50.170:9095/dashboardNew/
27. Artawan, I Made Dwi, et all. Karakteristik pasien anak dengan infeksi dengue di RSUP Sanglah tahun 2013-2014. Medicina. 2016: 158-162.
28. Trisnadewi NNL, Wande IN. Pola Serologi IgM dan IgG pada Infeksi Demam Berdarah Dengue (DBD) Rumah Sakit Umum Pusat Sanglah, Denpasar, Bali Bulan Agustus Sampai September 2014 . Medika. 2016;5.
29. Moeloek HA. Karakteristik Infeksi Dengue Dengan Kebocoran Plasma Di RSUD Dr.H. Abdul Moeloek Tahun 2018-2019. Jurnal Medula. 2019;9(3):520-525.
30. Lovera D, Martínez-Cuellar C, Galeano F, Amarilla S, Vazquez C, Arbo A. Clinical manifestations of primary and secondary dengue in Paraguay and its relation to virus serotype. The Journal of Infection in Developing Countries. 2019;13(12):1127-1134. doi:10.3855/jidc.11584.
31. Rasyidah G, Anandani A. Clinical Characteristic of Adults Patients With Dengue Hemmorragic Fever at Prof. Dr. Sulianti Saroso Sunter Infectious Hospital 2018. Muhammadiyah Medical Journal. 2020;1(1):26–32.
32. Vo HTM, Duong V, Ly S, Li QZ, Dussart P, Cantaert T. Autoantibody Profiling in Plasma of Dengue Virus–Infected Individuals. Pathogens. 2020;9(12):1060. doi:10.3390/PATHOGENS9121060
33. Gutiérrez-Barbosa H;, Lyke KE;, Leguia M, et al. Immune-Mediated Pathogenesis in Dengue Virus Infection. Viruses.2022;14(11):2575. doi:10.3390/V14112575
34. Stiasny K, Malafa S, Aberle SW, et al. Different cross-reactivities of igm responses in dengue, zika and tick-borne encephalitis virus infections. Viruses. 2021;13(4). doi:10.3390/v13040596
35. Haq FU, Imran M, Aslam Z, et al. Severity of Dengue Viral Infection Based on Clinical and Hematological Parameters among Pakistani Patients. Am J Trop Med Hyg. 2023. doi:10.4269/ajtmh.23-0309
Authors
Havel, I. I., Firmanti, S. C., Hadi, P., & Hapsari, R. (2026). Association Between Anti-Dengue IgM/IgG Serological Profile Results and the Severity of Dengue Infection. JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG, 18(1), 203–213. https://doi.org/10.34011/juriskesbdg.v18i1.3215
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