Application of ribavirin in patients having hemorrhagic fever with renal syndrome

摘要

Introduction. Hemorrhagic fever with renal syndrome (HFRS) is an acute infective disease of a zoonose type characterized by an abrupt beginning, prominent hemorrhagic syndrome as well as symptoms and signs of acute renal insufficiency. The clinical picture of this disease, which is leading in terms of its natural principal seat in the region of Northern-east Montenegro, ranges from non-apparent to very severe forms and mortality it causes is about 10%.Up to date, no efficient etio-trophic means has been discovered. Several studies suggest that an early use of anti virus medicament Ribavirine leads to decrease of mortality rate. The main aim of this study is to present our results achieved in an attempt to apply this medicament in treating HFRS. Material and methods. In total, we have treated 58 patients with symptoms and signs of HGSBS. Five of them, who were admitted to the Department in the first three days were treated by Ribavirine orally in doses of 2x400 mg. Compared to patients who were not treated by Ribavirine, a faster decrease of thrombocytes was noticed in them, which required the discontinuation of the medicament treatment. Thereafter, thrombocytes started to increase and their normalization followed faster than in patients who were not treated by this medicament. The above patients developed a moderately severe clinical picture of the disease, and middle maximum values of urea and creatinine were lower in patients who were not treated by the medicament. No patient developed a severe form of the disease and there were neither dialyzed nor died ones. The mortality rate in patients who were not treated by the medicament was 3.44% and the percent of the dialyzed was 5.17%. Results. Application of Ribavirine at the very beginning of HFRS is considered to be with a very good reason in combination with obligatory follow up of clinical and laboratory parameters and particularly of thrombocyte values, the decrease of which can lead to spontaneous bleedings. Because of the small number of patients to whom we gave this medicament it is difficult to come to a conclusion on the extent of its affect on the clinical picture in our patients.