How is Hantavirus pulmonary syndrome treated?
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Treatment of Hantavirus Pulmonary Syndrome (HPS)
Overview of Hantavirus Pulmonary Syndrome (HPS)
Hantavirus Pulmonary Syndrome (HPS) is a severe respiratory disease caused by hantaviruses, with a high mortality rate of approximately 30-50% in the Americas1 4. The disease is characterized by acute respiratory failure, mild to moderate renal failure, thrombocytopenia, and reactive lymphocytosis3. Early diagnosis and prompt treatment are crucial for improving patient outcomes.
Supportive Care and Mechanical Ventilation
The primary treatment for HPS involves supportive care, focusing on maintaining cardiovascular, respiratory, and renal function. Fluid and electrolyte homeostasis are critical components of care3. Mechanical ventilation is often required for patients experiencing severe respiratory distress. Early initiation of mechanical ventilation and careful volume administration are recommended, especially in intensive care units6.
Extracorporeal Membrane Oxygenation (ECMO)
Extracorporeal Membrane Oxygenation (ECMO) has shown promise as a rescue therapy for patients with severe cardiopulmonary failure due to HPS. ECMO provides cardiopulmonary support, allowing the lungs and heart to rest and recover. Case studies have demonstrated that ECMO can significantly improve survival rates in critically ill HPS patients2 3 7. In one study, two out of three patients with severe HPS who received ECMO survived and were discharged without complications2.
Antiviral Treatments
Favipiravir (T-705)
Favipiravir, a broad-spectrum antiviral agent, has shown efficacy against hantaviruses in vitro and in animal models. Studies have demonstrated that Favipiravir can significantly reduce viral RNA and antigen levels in tissue specimens and improve survival rates in animal models infected with hantaviruses4. This suggests that Favipiravir could be a potential therapeutic option for HPS, particularly for post-exposure prophylaxis.
Ribavirin
Ribavirin, another antiviral drug, is currently being evaluated in clinical trials for its effectiveness against HPS. Although the results are still pending, Ribavirin has shown some promise in reducing the severity of the disease in earlier studies7.
Immunotherapy and Vaccination
Passive Immunotherapy
Passive immunotherapy using sera from vaccinated individuals has shown potential in animal models. In a study involving rhesus macaques, sera from vaccinated monkeys provided protection against lethal HPS when administered to hamsters either before or shortly after exposure to the virus8. This approach could offer a post-exposure treatment option for individuals at high risk of HPS.
Vaccine Development
Efforts are ongoing to develop vaccines against hantaviruses. A DNA vaccine based on the Andes virus M genome segment has shown promise in preclinical studies, eliciting high levels of neutralizing antibodies in vaccinated animals8. However, no FDA-approved vaccines are currently available for HPS5.
Conclusion
The treatment of Hantavirus Pulmonary Syndrome primarily involves supportive care, including mechanical ventilation and fluid management. ECMO has emerged as a beneficial therapy for severe cases, significantly improving survival rates. Antiviral agents like Favipiravir and Ribavirin are under investigation and show promise in preclinical and clinical studies. Additionally, passive immunotherapy and vaccine development offer potential future avenues for preventing and treating HPS. Early diagnosis and prompt initiation of these treatments are crucial for improving patient outcomes.
Sources and full results
Most relevant research papers on this topic
Treatment of hantavirus pulmonary syndrome.
Effective therapeutics for hantavirus pulmonary syndrome (HPS) could reduce the high mortality rate and improve treatment and prevention of the disease.
Successful treatment of adults with severe Hantavirus pulmonary syndrome with extracorporeal membrane oxygenation.
ECMO is a beneficial therapy for critically ill patients with severe Hantavirus pulmonary syndrome, providing cardiopulmonary support and a good outcome in two cases.
Hantavirus infections for the clinician: From case presentation to diagnosis and treatment
Hantavirus infections cause Hantavirus Pulmonary Syndrome (HPS) and Hemorrhagic Fever with Renal Syndrome (HFRS), with common symptoms due to increased vascular permeability and immune activation.
Antiviral Efficacy of Favipiravir against Two Prominent Etiological Agents of Hantavirus Pulmonary Syndrome
Favipiravir (T-705) effectively inhibits Sin Nombre virus and Andes virus, suggesting it as a potential postexposure prophylaxis against hantavirus pulmonary syndrome-causing viruses.
Progress on the Prevention and Treatment of Hantavirus Disease
Hantavirus diseases have no FDA-approved vaccines or treatments, but vaccines and antiviral treatments are in development for various animal models and human clinical trials.
[Hantavirus pulmonary and cardiovascular syndrome: epidemiology, clinical presentation, laboratory diagnosis and treatment].
Hantavirus pulmonary and cardiovascular syndrome (HPCVS) is an emerging disease in Brazil, with high mortality rates and requires early diagnosis and treatment.
Hantavirus pulmonary syndrome in the United States
Hantavirus pulmonary syndrome (HPS) is a widespread and potentially fatal disease, with new research identifying cellular receptors and the immune system's role in pathogenesis.
Active and Passive Vaccination against Hantavirus Pulmonary Syndrome with Andes Virus M Genome Segment-Based DNA Vaccine
A gene-based HPS vaccine, pWRG/AND-M, shows potential as a postexposure immunoprophylactic for protecting individuals after exposure to highly lethal hantaviruses.
Hantavirus Pulmonary Syndrome in a COVID-19 Patient, Argentina, 2020
Hantavirus pulmonary syndrome (HPS) can be fatal when co-infected with COVID-19, but HPS is more lethal and should be detected and treated promptly in HPS-endemic regions.
Hantavirus induced cardiopulmonary syndrome: A public health concern
Hantavirus cardiopulmonary syndrome is a fatal illness with high mortality rates, but early diagnosis and appropriate treatment can improve outcomes.
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