title: Failure of interferon alfa and tribavirin in rabies encephalitis.
abstract: OBJECTIVE
  To test the effect of interferon alfa and tribavirin (ribavirin) in patients with rabies encephalitis.
  
  
  METHODS
  An open trial of chemotherapy and intensive care in patients with early rabies.
  
  
  METHODS
  The intensive care unit of a Bangkok hospital.
  
  
  METHODS
  Four conscious men with clinical rabies encephalitis.
  
  
  METHODS
  Rapid virological diagnosis of rabies. Treatment with intravenous and intraventricular injections of high doses of lymphoblastoid interferon alfa in three patients and tribavirin in one patient. Intensive care was given throughout.
  
  
  METHODS
  Rabies infection confirmed by antigen detection and virus isolation. Rabies neutralising antibody and specific IgM sought in serum and cerebrospinal fluid. Interferon concentrations monitored before and during treatment in three patients.
  
  
  RESULTS
  Interferon alfa treatment produced high concentrations in serum and cerebrospinal fluid. All four patients died after 5 1/2 to 12 1/2 days of treatment with no evidence of virostatic or clinically beneficial effects from either treatment.
  
  
  CONCLUSIONS
  Interferon alfa treatment is not effective in rabies encephalitis. The use of tribavirin warrants further study, possibly combined with new therapeutic methods.
authors.affiliation: Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: M J
authors.initials: MJ
authors.lastname: Warrell
authors.forename: N J
authors.initials: NJ
authors.lastname: White
authors.forename: S
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: R E
authors.initials: RE
authors.lastname: Phillips
authors.forename: P
authors.initials: P
authors.lastname: Suntharasamai
authors.forename: P
authors.initials: P
authors.lastname: Chanthavanich
authors.forename: M
authors.initials: M
authors.lastname: Riganti
authors.forename: S P
authors.initials: SP
authors.lastname: Fisher-Hoch
authors.forename: K G
authors.initials: KG
authors.lastname: Nicholson
authors.forename: S
authors.initials: S
authors.lastname: Manatsathit
mesh_terms: D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D004660:Encephalitis / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007370:Interferon Type I / Q000134:cerebrospinal fluid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011818:Rabies / Q000134:cerebrospinal fluid / Q000150:complications / Q000188:drug therapy*; D012254:Ribavirin / Q000627:therapeutic use*; D012263:Ribonucleosides / Q000627:therapeutic use*
chemical_list: D007370:Interferon Type I; D012263:Ribonucleosides; D012254:Ribavirin