title: Efficacy of oral ribavirin treatment in Crimean-Congo haemorrhagic fever: a quasi-experimental study from Turkey.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of oral ribavirin treatment in patients with Crimean-Congo haemorrhagic fever (CCHF).
  
  
  METHODS
  In 2004, all patients diagnosed with CCHF were treated with oral ribavirin, however in 2003 none of the CCHF patients had been given treatment due to lack of confirmatory diagnostic information at that time in Turkey. In this study, patients treated with ribavirin in 2004 (n=126) were compared with ribavirin-untreated CCHF patients (n=92) in 2003. Patients only with a definitive diagnosis of CCHF (clinical symptoms plus the presence of specific IgM antibodies against CCHF virus and presence of viral antigen) were included in this study.
  
  
  RESULTS
  There was no difference in the case-fatality rate between treated and untreated patients (7.1% vs. 11.9%; P>0.05). A Cox Proportional Hazards regression analysis revealed that altered sensorium and prolonged international normalized ratio were independent predictors of mortality.
  
  
  CONCLUSIONS
  Our results showed that oral ribavirin treatment did not improve the survival rate in CCHF patients. Ribavirin and supportive care are the only available choices for treatment of CCHF patients, but to ascertain the efficacy of ribavirin, more laboratory and observational studies are necessary and ultimately, to elucidate these conflicting results and evaluate the efficacy undoubtedly, a multicenter randomised controlled trial will be needed.
authors.affiliation: Department of Infectious Diseases and Clinical Bacteriology, Cumhuriyet University, Sivas, Turkey.
authors.forename: Nazif
authors.initials: N
authors.lastname: Elaldi
authors.forename: Hurrem
authors.initials: H
authors.lastname: Bodur
authors.forename: Sibel
authors.initials: S
authors.lastname: Ascioglu
authors.forename: Aysel
authors.initials: A
authors.lastname: Celikbas
authors.forename: Zulal
authors.initials: Z
authors.lastname: Ozkurt
authors.forename: Haluk
authors.initials: H
authors.lastname: Vahaboglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Leblebicioglu
authors.forename: Neziha
authors.initials: N
authors.lastname: Yilmaz
authors.forename: Aynur
authors.initials: A
authors.lastname: Engin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sencan
authors.forename: Kemalettin
authors.initials: K
authors.lastname: Aydin
authors.forename: Ilyas
authors.initials: I
authors.lastname: Dokmetas
authors.forename: Mustafa Aydin
authors.initials: MA
authors.lastname: Cevik
authors.forename: Basak
authors.initials: B
authors.lastname: Dokuzoguz
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Tasyaran
authors.forename: Recep
authors.initials: R
authors.lastname: Ozturk
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bakir
authors.forename: Ramazan
authors.initials: R
authors.lastname: Uzun
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000187:drug effects* / Q000302:isolation & purification; D006479:Hemorrhagic Fever, Crimean / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D007074:Immunoglobulin G; D012254:Ribavirin