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The efficacy of ribavirin treatment in Crimean-Congo haemorrhagic fever in Turkey

Abstract number: P1398

Tuncer Ertem G., Temocin F., Ataman Hatipoglu C., Sonmezer M., Oral B., Tulek N.

Objectives: Bunyaviridae family are known as generally sensitive to ribavirin. It was shown that ribavirin is effective against Crimean-Congo Haemorrhagic Fever (CCHF) in vitro and the positive effect of ribavirin was reported in some studies. However there are no randomized controlled clinical trials, ribavirin use in treatment of CCHF is suggested by World Health Organization. The aim of the study is to analyze the effect of ribavirin use on clinical course of the disease.

Methods: All patients with CCHF hospitalized at our clinic between 2007 and 2009 in Ankara Training and Research Hospital were evaluated retrospectively. All of the cases were confirmed at National Reference Laboratory by presence of IgM positivity by ELISA or positive RT-PCR tests. The patients were grouped on the basis of ribavirin use or not. Patients who did not use ribavirin served as control group. Then the patients who treated with ribavirin grouped according to receiving within 3 days of the onset of symptoms (Group 1) or later (Group 2). The levels of laboratory findings at the beginning, 5th day and end of treatment were compared for evaluation of the efficacy of ribavirin.

Results: Eighty-nine patients (48 female and 41 male) were included in our study. The mean of age the patients was 48 years (range: 16–80 years). Two patients were died (2.2%). Fourty-six (51.7%) of patients received oral ribavirin, 43 (48.3%) of not received. Died patients had entered to the hospital later (geqslant R: gt-or-equal, slanted3 days) but both of them received ribavirin. One of them died on next day of admission, other died four days later. The mean of platelet values was significantly higher in ribavirin receiving group on 5th day of treatment (p = 0.04). The mean of activated partial thromboplastin time (APTT) values on 5th day and prothrombin time (PT) values on 10th day were lower in ribavirin group (respectively p = 0.04, p = 0.004). Aspartate aminotransferase (AST), lactate dehydrogenase (LDH) levels, platelet and APTT values rapidly normalized in ribavirin receiving group compared with nonreceiving group (respectively p = 0.009, p = 0.018, p = 0.000, p = 0.015). There were no statistically difference for mean of leukocyte, alanine aminotransferase (ALT), AST, LDH and creatine kinase (CK) levels in group 1 and 2. PLT values rapidly normalized in group 1 (p = 0.033), but for other parameters no difference was found.

Conclusion: We found a useful effect of ribavirin treatment especially on platelet, APTT, AST and LDH levels.

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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