TY - JOUR
T1 - Hemorrhagic Fever Caused by a Novel Bunyavirus in China: Pathogenesis and Correlates of Fatal Outcome
AU - Zhang, Yong-Zhen
AU - He, Yong-Wen
AU - Dai, Yong-An
AU - Xiong, Yanwen
AU - Zheng, Han
AU - Zhou, Dun-Jin
AU - Li, Juan
AU - Sun, Qiangzheng
AU - Luo, Xue-Lian
AU - Cheng, Yu-Li
AU - Qin, Xin-Cheng
AU - Tian, Jun-Hua
AU - Chen, Xiao-Ping
AU - Yu, Bin
AU - Jin, Dong
AU - Guo, Wen-Ping
AU - Li, Wei
AU - Wang, Wen
AU - Peng, Jin-Song
AU - Zhang, Guo-Bin
AU - Zhang, Shaomin
AU - Chen, Xiao-Min
AU - Wang, Yan
AU - Li, Ming-Hui
AU - Li, Zhenjun
AU - Lu, Shan
AU - Ye, Changyun
AU - de Jong, Menno D.
AU - Xu, Jianguo
PY - 2012
Y1 - 2012
N2 - 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-c), 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
AB - 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-c), 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
U2 - https://doi.org/10.1093/cid/cir804
DO - https://doi.org/10.1093/cid/cir804
M3 - Article
C2 - 22144540
SN - 1058-4838
VL - 54
SP - 527
EP - 533
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 4
ER -