Intravenous ribavirin for hantavirus pulmonary syndrome: Safety and tolerance during 1 year of open-label experience

Louisa E. Chapman, Gregory J. Mertz, Clarence J. Peters, Heidi M. Jolson, Ali S. Khan, Thomas Ksiazek, Frederick T. Koster, Kenneth F. Baum, Pierre E. Rollin, Andrew T. Pavia, Robert C. Holman, John C. Christenson, Phillip J. Rubin, Rachel E. Behrman, Linda J. Wilson Bell, Gary L. Simpson, Ramses F. Sadek

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Intravenous ribavirin was provided non-selectively for investigational open-label use among persons with suspected hantavirus pulmonary syndrome (HPS) in the United States between 4 June 1993 and 1 September 1994. Therapy was initiated prior to laboratory confirmation of hantavirus infection because most deaths from HPS occur within 48 h of hospitalization. Thirty patients with confirmed HPS, 105 patients without HPS and 5 patients without adequate diagnostic testing for HPS were enrolled. This observational study arguably provides the most complete information available on ribavirin-associated adverse effects. Although ribavirin was generally well tolerated, 71% of recipients became anaemic and 19% underwent transfusion. An apparent excess of hyperamylasaemia/pancreatitis was either therapy-associated or due to enrolment bias. The 30 enrolled HPS patients had a case-fatality rate of 47% (14/30), it is not possible to assess efficacy with this study design. However, comparison of survival curves for the 30 enrolled HPS patients and 34 patients who developed HPS during the same time period but were not enrolled did not suggest an appreciable drug effect, A randomized, placebo-controlled trial that enrols patients during the prodrome phase would be necessary to assess the efficacy and further define the safety of intravenous ribavirin for HPS.

Original languageEnglish (US)
Pages (from-to)211-219
Number of pages9
JournalAntiviral Therapy
Volume4
Issue number4
StatePublished - 1999
Externally publishedYes

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Hantavirus Pulmonary Syndrome
Ribavirin
Safety
Hantavirus Infections
Pancreatitis
Observational Studies
Hospitalization
Randomized Controlled Trials
Placebos

ASJC Scopus subject areas

  • Pharmacology

Cite this

Chapman, L. E., Mertz, G. J., Peters, C. J., Jolson, H. M., Khan, A. S., Ksiazek, T., ... Sadek, R. F. (1999). Intravenous ribavirin for hantavirus pulmonary syndrome: Safety and tolerance during 1 year of open-label experience. Antiviral Therapy, 4(4), 211-219.

Intravenous ribavirin for hantavirus pulmonary syndrome : Safety and tolerance during 1 year of open-label experience. / Chapman, Louisa E.; Mertz, Gregory J.; Peters, Clarence J.; Jolson, Heidi M.; Khan, Ali S.; Ksiazek, Thomas; Koster, Frederick T.; Baum, Kenneth F.; Rollin, Pierre E.; Pavia, Andrew T.; Holman, Robert C.; Christenson, John C.; Rubin, Phillip J.; Behrman, Rachel E.; Wilson Bell, Linda J.; Simpson, Gary L.; Sadek, Ramses F.

In: Antiviral Therapy, Vol. 4, No. 4, 1999, p. 211-219.

Research output: Contribution to journalArticle

Chapman, LE, Mertz, GJ, Peters, CJ, Jolson, HM, Khan, AS, Ksiazek, T, Koster, FT, Baum, KF, Rollin, PE, Pavia, AT, Holman, RC, Christenson, JC, Rubin, PJ, Behrman, RE, Wilson Bell, LJ, Simpson, GL & Sadek, RF 1999, 'Intravenous ribavirin for hantavirus pulmonary syndrome: Safety and tolerance during 1 year of open-label experience', Antiviral Therapy, vol. 4, no. 4, pp. 211-219.
Chapman, Louisa E. ; Mertz, Gregory J. ; Peters, Clarence J. ; Jolson, Heidi M. ; Khan, Ali S. ; Ksiazek, Thomas ; Koster, Frederick T. ; Baum, Kenneth F. ; Rollin, Pierre E. ; Pavia, Andrew T. ; Holman, Robert C. ; Christenson, John C. ; Rubin, Phillip J. ; Behrman, Rachel E. ; Wilson Bell, Linda J. ; Simpson, Gary L. ; Sadek, Ramses F. / Intravenous ribavirin for hantavirus pulmonary syndrome : Safety and tolerance during 1 year of open-label experience. In: Antiviral Therapy. 1999 ; Vol. 4, No. 4. pp. 211-219.
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