Abstract
Dear Editor:
We read the publication of “AA IDO1 Variant Genotype (G2431A, rs3739319) Is Associated with Severe Dengue Risk Development in a DEN-3 Brazilian Cohort” with great interest (1). Azevedo et al. concluded that “Our data show an association between the IDO G2431A variant and the risk for SD (1).” We would like to share ideas on this report. First, the variant G to A of IDO1 is a genetic change that can result in molecular change. The effect on the final phenotypic expression might be expected similar to the observed phenomenon in reported clinical interrelationship of other A—G altering genetic variant (2). Nevertheless, in the present cohort by Azevedo et al. (1), based on Hardy–Weinberg genetic equilibrium (3,4), there is no normal distribution and the Yates correction was used (1). Nevertheless, the derived odds ratio should be further adjusted. Confounding adjusted odd ratio should be calculated (5). At least the adjustment for confounding factors is needed. The important confounding factors include demographic background (age, gender, ethnicity, etc.) and other genetic factors that might affect dengue severity [such as MICB, TNF, CD209, FcγRIIA, TPSAB1, CLEC5A, IL10, and PLCE1 gene variants (6)]. Finally, the severity of dengue is not totally based on genetic underlying factors. For example, shock can be controlled if there is a good early fluid replacement therapy for dengue patients (7).
The good clinical management can result in good clinical outcome of dengue care (7).
Footnotes
Author Disclosure Statement
No competing financial interests exist.