Program Schedule

1157
Crucial Parameter of the Outcome in Crimean Congo Hemorrhagic Fever: Viral Load

Session: Poster Abstract Session: Viral Infections: Pathogenesis
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Crimean Congo hemorrhagic fever (CCHF), which is endemic in our country, is the widest spread of the viral hemorrhagic fevers. In our study relation of viral load with mortality and clinical and laboratory findings were evaluated retrospectively.

Methods: A total of 126 patients that were treated in our clinic with diagnosis of CCHF between 2008 and 2013 were included in the study. Routine laboratory parameters were taken from hospital records whereas measurement of CCHF viral load were performed from serum samples conserved at -80°C with Real Time PCR. 

Results: In our study, mortality rate was 11.1%. The most important prognostic factor was found to be viral load with a mean of 8,3x107 copy/ml in patients who survived and 4,6x109 copy/ml in patients who died. As viral load increases PT and aPTT times significantly extend; INR, AST, ALT, CPK, LDH, and creatinine levels rise and the probability of bleeding and seizure significantly increase. Any of the patients who had viral load greater than 2x109 copy/ml survived.

When cut-off value that can estimate the prognosis is calculated, probability of survival is found to be significantly reduced where viral load > 1.03x 108 copy/ml. Patients were categorized according to their viral load with a cut-off value of 108 copy/ml. While no significant differences were found for frequency of fever, myalgia, nausea and vomiting and abdominal pain; patients with 108 copy/ml or higher viral load had diarrhea, headache and unconsciousness significantly more frequently. Among clinical findings; bleeding, seizure and haemodialysis were significantly more frequent in patients with viral load 108 copy/ml or higher (p<0.05). WBC, haemoglobin, and platelet counts were significantly lower in patients who had 108 copy/ml or higher viral load whereas AST, ALT, CPK, LDH, creatinine levels, PT and aPTT time, D-dimer levels and INR were found to be significantly higher among same patients. All blood product transfusions were significantly used more in patients who had viral load > 108 copy/ml.

Conclusion: Our study has the largest number of patients among studies which evaluate viral load on CCHF. As in all other studies, our study shows that viral load is the most effective parameter on mortality and as viral load increases survival rate significantly decreases.

Imran Hasanoglu, MD, Infectious Diseases and Clinical Microbiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey, Rahmet Guner, Prof., Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Medical School, Ankara, Turkey, Ahmet Carhan, Ass. Prof., Medical Biology, Yildirim Beyazıit University School of Medicine, Ankara, Turkey, Zeliha Kocak Tufan, Ass. Prof., Infectious Diseases and Clinical Microbiology, Yildirim Beyaz─▒it University School of Medicine, Ankara, Turkey, Dilek Yagci Caglayik, MD, National Arbovirus and Viral Zoonoses Reference and Research Laboratory, Public Health Institute of Turkey, Ankara, Turkey, Gul Ruhsar Yilmaz, Ass. Prof., Infectious Diseases and Clinical Microbiology, Ataturk Education and Research Hospital, Ankara, Turkey, Tumer Guven, MD, Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University School of Medicine, Ankara, Turkey and Mehmet a. Tasyaran, Prof. Dr., Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey

Disclosures:

I. Hasanoglu, None

R. Guner, None

A. Carhan, None

Z. Kocak Tufan, None

D. Yagci Caglayik, None

G. R. Yilmaz, None

T. Guven, None

M. A. Tasyaran, None

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