Prospective, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin therapy of hemorrhagic fever with renal syndrome.
A prospective, randomized, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin (loading dose of 33 mg/kg, 16 mg/kg every 6 h for 4 days, and 8 mg/kg every 8 h for 3 days) was conducted in 242 patients with serologically confirmed hemorrhagic fever with renal syndrome (HFRS) in the People's Republic of China. Mortality was significantly reduced (sevenfold decrease in risk) among ribavirin-treated patients, when comparisons were adjusted for baseline risk estimators of mortality (P = .01; two-tailed). HFRS typically consists of five consecutive but frequently overlapping clinical phases. Only occurrence of oliguric phase and hemorrhage was associated with severity of clinical disease in the placebo group. Ribavirin therapy also resulted in a significant reduction in the risk of entering the oliguric phase and experiencing hemorrhage. The only ribavirin-related side effect was a well-recognized, fully reversible anemia after completion of therapy.
Division of Virology (Department of Antiviral Studies), US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702-5011.
J W
JW
Huggins
C M
CM
Hsiang
T M
TM
Cosgriff
M Y
MY
Guang
J I
JI
Smith
Z O
ZO
Wu
J W
JW
LeDuc
Z M
ZM
Zheng
J M
JM
Meegan
Q N
QN
Wang
D000743:Anemia, Hemolytic / Q000139:chemically induced; D004311:Double-Blind Method; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D005500:Follow-Up Studies; D006476:Orthohantavirus / Q000276:immunology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007022:Hypotension / Q000188:drug therapy / Q000209:etiology; D007075:Immunoglobulin M / Q000097:blood; D007275:Injections, Intravenous; D015993:Life Tables; D008297:Male; D009846:Oliguria / Q000188:drug therapy / Q000209:etiology; D011141:Polyuria / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D007075:Immunoglobulin M; D012254:Ribavirin