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Hemorrhagic Fever Caused by a Novel Bunyavirus in China: Pathogenesis and Correlates of Fatal Outcome
- Source :
- Clinical infectious diseases, 54(4), 527-533. Oxford University Press
- Publication Year :
- 2012
-
Abstract
- Background Hemorrhagic fever-like illness caused by a novel Bunyavirus, Huaiyangshan virus (HYSV, also known as Severe Fever with Thrombocytopenia virus [SFTSV] and Fever, Thrombocytopenia and Leukopenia Syndrome [FTLS]), has recently been described in China. Methods Patients with laboratory-confirmed HYSV infection who were admitted to Union Hospital or Zhongnan Hospital between April 2010 and October 2010 were included in this study. Clinical and routine laboratory data were collected and blood, throat swab, urine, or feces were obtained when possible. Viral RNA was quantified by real-time reverse-transcriptase polymerase chain reaction. Blood levels of a range of cytokines, chemokines, and acute phase proteins were assayed. Results A total of 49 patients with hemorrhagic fever caused by HYSV were included; 8 (16.3%) patients died. A fatal outcome was associated with high viral RNA load in blood at admission, as well as higher serum liver transaminase levels, more pronounced coagulation disturbances (activated partial thromboplastin time, thrombin time), and higher levels of acute phase proteins (phospholipase A, fibrinogen, hepcidin), cytokines (interleukin [IL]-6, IL-10, interferon-γ), and chemokines (IL-8, monocyte chemotactic protein 1, macrophage inflammatory protein 1b). The levels of these host parameters correlated with viral RNA levels. Blood viral RNA levels gradually declined over 3-4 weeks after illness onset, accompanied by resolution of symptoms and laboratory abnormalities. Viral RNA was also detectable in throat, urine, and fecal specimens of a substantial proportion of patients, including all fatal cases assayed. CONCLUSIONS. Viral replication and host immune responses play an important role in determining the severity and clinical outcome in patients with infection by HYSV.
- Subjects :
- Microbiology (medical)
Adult
Male
China
Hemorrhagic Fevers, Viral
Orthobunyavirus
Urine
Bunyaviridae Infections
Real-Time Polymerase Chain Reaction
Virus
Feces
Blood serum
Risk Factors
Medicine
Humans
Prospective Studies
Macrophage inflammatory protein
Aged
medicine.diagnostic_test
business.industry
Acute-phase protein
Middle Aged
Viral Load
medicine.disease
Survival Analysis
Severe fever with thrombocytopenia syndrome
Infectious Diseases
Blood
Immunology
Pharynx
RNA, Viral
Female
business
Viral load
Severe fever with thrombocytopenia syndrome virus
Partial thromboplastin time
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 54
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Clinical infectious diseases
- Accession number :
- edsair.doi.dedup.....605a743ebac98f456a4887313ae0a2ab