Crimean-Congo hemorrhagic fever in Eurasia in XXI century: Pathogenesis and treatment

Platonov A.E., Maleev V.V., Sannikova I.V., Pasechnikov V.D., Karan L.S., Platonova O.V., Kulichenko A.N.

Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare, Moscow; State Medical Academy, Stavropol, Ministry of Health of Russia; Anti-Plague Institute, Stavropol, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare
The review considers the pathogenesis and treatment of Crimean-Congo hemorrhagic fever (CCHF). Antiviral cellular defense mechanisms include «cytoplasmic sensors» (proteins recognizing viral RNA), interferons, and interferon-stimulated genes and proteins. In some individuals CCHF virus may for unclear reasons overcome this defense and multiply in dendritic, endothelial and epithelial cells. In an experiment, if the interferon reception, or conducting of intracellular interferon-dependent signals, or interferon-related reaction are interrupted, so the propagation of CCHF virus cannot be controlled. In a clinical setting, the high concentration of CCHF virus in a patient’s blood is an unequivocal sign and, possibly, a cause of disease severity. Endothelium is damaged either by the virus itself or by hyperactivated blood cells that in severe cases leads to disseminated intravascular coagulation, multiple organ failure and death. The efficacy of antiviral drug ribavirin for the treatment of CCHF is considered using both the original publications and their meta-analysis. Despite of numerous uncertainties caused by the absence of the convincing data of randomized placebo-controlled trials, the early use of ribavirin is still the only option for etiotropic therapy of CCHF. We look forward to developing novel drugs based on specific small interfering RNAs or broad-spectrum antiviral therapeutics.


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About the Autors

Prof. Platonov Aleksandr Evgenievich, BD; Head, Laboratory for Epidemiology of Natural Focal Infections, Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare
Address: 3a, Novogireevskaya St., Moscow 111123
Telephone: (8-495)974-96-46

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