Ephraim Ogbaini-Emovon, George Akpede, Sylvanus Okogbenin, Emmanuel Osagiede, Ekaete Tobin, Danny Asogun, Peter Okokhere, Martha Okonofua, Nosa Akpede, Peter Akhideno, Cyril Erameh, Mojeed Rafiu, Chukwuemeka Azubuike, Kelly Iraoya, Chris Iruolagbe, Christian Erohubie, Dazumi Ahmed, Osahogie Ediawe, Joseph Okoguale, Reuben Eifediyi, Ikponmwonsa Odia, Jacqueline Agbukor, Donatus Adomeh, Maxy A C Odike, Wilson Ovienria, Anieno Elkanem, Ekene B Muoebenam, Kingsley C Ojide, Elisa Pallasch, Jonas Müller, Julia Hinzmann, Stephan Günther, Meike Pahlmann, Anke Thielebein, Sophie Duraffour, Lisa Oestereich, Ralf Krumkamp
{"title":"接受利巴韦林治疗的拉沙热患者的病毒载量动力学：尼日利亚南部的一项回顾性队列研究。","authors":"Ephraim Ogbaini-Emovon, George Akpede, Sylvanus Okogbenin, Emmanuel Osagiede, Ekaete Tobin, Danny Asogun, Peter Okokhere, Martha Okonofua, Nosa Akpede, Peter Akhideno, Cyril Erameh, Mojeed Rafiu, Chukwuemeka Azubuike, Kelly Iraoya, Chris Iruolagbe, Christian Erohubie, Dazumi Ahmed, Osahogie Ediawe, Joseph Okoguale, Reuben Eifediyi, Ikponmwonsa Odia, Jacqueline Agbukor, Donatus Adomeh, Maxy A C Odike, Wilson Ovienria, Anieno Elkanem, Ekene B Muoebenam, Kingsley C Ojide, Elisa Pallasch, Jonas Müller, Julia Hinzmann, Stephan Günther, Meike Pahlmann, Anke Thielebein, Sophie Duraffour, Lisa Oestereich, Ralf Krumkamp","doi":"10.1093/ofid/ofae575","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The standard of care for Lassa fever is the use of ribavirin with supportive therapy. There is little information on the course of viremia and its relationship with clinical outcomes in patients treated with ribavirin.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of virologic and clinical parameters of 152 reverse transcription polymerase chain reaction-confirmed Lassa fever cases admitted and treated with ribavirin therapy. We describe the Lassa virus RNA kinetics in blood in relation to the clinical course of the patients.</p><p><strong>Results: </strong>The overall mortality was 9%. The median duration (interquartile range [IQR]) of illness before admission was 8 (5-12) days. Median (IQR) Ct values on admission (<i>t<sub>0</sub></i> ) were lower among patients who died (21 [20-27]) than in those who survived (34 [30-37]; <i>P</i> < .01). The receiver operating characteristics curve of the association between outcome and Ct value at <i>t<sub>0</sub></i> had a high classification performance, with an AUC of 0.92 (95% CI, 0.86-0.98). The median time to viral clearance (IQR) was 10 (5-15) days. The viral load decreased steadily with the duration of treatment, and all survivors achieved viral clearance within 25 days of hospitalization.</p><p><strong>Conclusions: </strong>Our study demonstrates that the Ct value on admission has prognostic value and Lassa fever patients treated with ribavirin typically clear the virus within 3-4 weeks of hospitalization. This kinetics has implications for the design of clinical case management and future clinical trial protocols.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 10","pages":"ofae575"},"PeriodicalIF":3.8000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500659/pdf/","citationCount":"0","resultStr":"{\"title\":\"Virus Load Kinetics in Lassa Fever Patients Treated With Ribavirin: A Retrospective Cohort Study From Southern Nigeria.\",\"authors\":\"Ephraim Ogbaini-Emovon, George Akpede, Sylvanus Okogbenin, Emmanuel Osagiede, Ekaete Tobin, Danny Asogun, Peter Okokhere, Martha Okonofua, Nosa Akpede, Peter Akhideno, Cyril Erameh, Mojeed Rafiu, Chukwuemeka Azubuike, Kelly Iraoya, Chris Iruolagbe, Christian Erohubie, Dazumi Ahmed, Osahogie Ediawe, Joseph Okoguale, Reuben Eifediyi, Ikponmwonsa Odia, Jacqueline Agbukor, Donatus Adomeh, Maxy A C Odike, Wilson Ovienria, Anieno Elkanem, Ekene B Muoebenam, Kingsley C Ojide, Elisa Pallasch, Jonas Müller, Julia Hinzmann, Stephan Günther, Meike Pahlmann, Anke Thielebein, Sophie Duraffour, Lisa Oestereich, Ralf Krumkamp\",\"doi\":\"10.1093/ofid/ofae575\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The standard of care for Lassa fever is the use of ribavirin with supportive therapy. There is little information on the course of viremia and its relationship with clinical outcomes in patients treated with ribavirin.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of virologic and clinical parameters of 152 reverse transcription polymerase chain reaction-confirmed Lassa fever cases admitted and treated with ribavirin therapy. We describe the Lassa virus RNA kinetics in blood in relation to the clinical course of the patients.</p><p><strong>Results: </strong>The overall mortality was 9%. The median duration (interquartile range [IQR]) of illness before admission was 8 (5-12) days. Median (IQR) Ct values on admission (<i>t<sub>0</sub></i> ) were lower among patients who died (21 [20-27]) than in those who survived (34 [30-37]; <i>P</i> < .01). The receiver operating characteristics curve of the association between outcome and Ct value at <i>t<sub>0</sub></i> had a high classification performance, with an AUC of 0.92 (95% CI, 0.86-0.98). The median time to viral clearance (IQR) was 10 (5-15) days. The viral load decreased steadily with the duration of treatment, and all survivors achieved viral clearance within 25 days of hospitalization.</p><p><strong>Conclusions: </strong>Our study demonstrates that the Ct value on admission has prognostic value and Lassa fever patients treated with ribavirin typically clear the virus within 3-4 weeks of hospitalization. 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Virus Load Kinetics in Lassa Fever Patients Treated With Ribavirin: A Retrospective Cohort Study From Southern Nigeria.
Background: The standard of care for Lassa fever is the use of ribavirin with supportive therapy. There is little information on the course of viremia and its relationship with clinical outcomes in patients treated with ribavirin.
Methods: We conducted a retrospective analysis of virologic and clinical parameters of 152 reverse transcription polymerase chain reaction-confirmed Lassa fever cases admitted and treated with ribavirin therapy. We describe the Lassa virus RNA kinetics in blood in relation to the clinical course of the patients.
Results: The overall mortality was 9%. The median duration (interquartile range [IQR]) of illness before admission was 8 (5-12) days. Median (IQR) Ct values on admission (t0 ) were lower among patients who died (21 [20-27]) than in those who survived (34 [30-37]; P < .01). The receiver operating characteristics curve of the association between outcome and Ct value at t0 had a high classification performance, with an AUC of 0.92 (95% CI, 0.86-0.98). The median time to viral clearance (IQR) was 10 (5-15) days. The viral load decreased steadily with the duration of treatment, and all survivors achieved viral clearance within 25 days of hospitalization.
Conclusions: Our study demonstrates that the Ct value on admission has prognostic value and Lassa fever patients treated with ribavirin typically clear the virus within 3-4 weeks of hospitalization. This kinetics has implications for the design of clinical case management and future clinical trial protocols.
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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