668. Ribavirin in treatment of Crimean-Congo Hemorrhagic Fever (CCHF): An international multicenter retrospective analysis
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • idweek2016 cchf.pdf (618.3 kB)
  • Background:CCHF is a fatal viral hemorrhagic illness transmitted by ticks with no proven antiviral treatment. While ribavirin has been proposed as a potential therapy, results of previous studies are not conclusive. This multi-centric study is aimed to evaluate the efficacy of Ribavirin in treatment of CCHF.

    Methods:In a multi-center, non-interventional, retrospective observational study, 543 Turkish and Iranian hospitalized CCHF patients were evaluated (2011-2015). Patients’ demographic, epidemiological, clinical characteristics, laboratory data, treatment and outcome variables were compared between patients who received ribavirin and supportive therapy and those who only received supportive therapy. Data analysis was performed by SPSS 16.0.

    Results:Data for 543 patients from 7 centers were reviewed (Table 1). Ribavirin was administered to 198 patients (36.5%) who were mainly younger than 65 years old (85%) and male (%65.2). Leukocyte count on admission was significantly higher in ribavirin group (P=0.023). PT and aPTT on admission were significantly higher in the ribavirin group (p=0.047 and 0.006, respectively), while bleeding was not significantly different (0.246). Platelets, Hemoglobin, liver enzymes, INR, CPK, LDH and D-Dimer levels on admission were not significantly different between groups. Ribavirin group had a significantly longer duration of hospitalization (7.4±3.3 vs. 7.3±5.6, P=0.042). Overall, 44 patients died of CCHF (8%). Mortality was observed in 15 patients who received ribavirin (7.6%) and in 29 (8.4%) patients in the non-ribavirin group. (P=0.733). Nine patients died within the first 3 days (3 received ribavirin). Time from hospitalization to death was 6.4±5.9 days in the ribavirin vs. 5.3±2.7 days in non-ribavirin group (p=0.867). During hospitalization, platelet counts were significantly lower in the ribavirin group (P<0.05), while leukocyte and hemoglobin counts were not significantly different (Table 2). Ribavirin group significantly needed more plasma transfusions (43.4% vs. 29.3%) (P=0.001). Need for platelet and erythrocyte transfusions were similar among two groups while in thrombocytopenic patients, ribavirin patients needed more frequent platelet transfusions (P=0.013).

    Conclusion:Our findings suggest that ribavirin use did not significantly improve outcome in CCHF patient.

    Gürdal Yilmaz, associated professor1, Mustafa Sunbul, proffessor2, Derya Yapar, MD3, Nurcan Baykam, proffessor3, Imran Hasanoglu, MD4, Rahmet Guner, Prof.4, Sener Barut, associated professor5, Emin Ediz Tutuncu, Assoc. Prof.6, Ferdi Gunes, assistant5, Firdevs Aksoy, Assistant Professor1, Selcuk Kaya, Associate Professor1, Ilkay Bozkurt, Assistant Professor2, Irfan Sencan, Prof.6, Parisa Khorgami, MD7, Naeimeh Fatollahzadeh, MD7, Maryam Keshtkar-Jahromi, MD, MPH8 and Iftihar Koksal, proffessor1, (1)Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey, (2)Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey, (3)Department of Infectious Diseases and Clinical Microbiology, Hitit University Medical School, Corum, Turkey, (4)Infectious Diseases and Clinical Microbiology, Yildirim Beyazit University School of Medicine, Ankara, Turkey, (5)Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University Medical School, Tokat, Turkey, (6)Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, (7)Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran (Islamic Republic of), (8)Medicine/ Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD

    Disclosures:

    G. Yilmaz, None

    M. Sunbul, None

    D. Yapar, None

    N. Baykam, None

    I. Hasanoglu, None

    R. Guner, None

    S. Barut, None

    E. E. Tutuncu, None

    F. Gunes, None

    F. Aksoy, None

    S. Kaya, None

    I. Bozkurt, None

    I. Sencan, None

    P. Khorgami, None

    N. Fatollahzadeh, None

    M. Keshtkar-Jahromi, None

    I. Koksal, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.