Congenital Anomalies Induced in Hamster Embryos with Ribavirin

Kilham, Lawrence; Ferm, Vergil H.

doi:10.1126/science.401547

Cited by 70 publications

(35 citation statements)

References 6 publications

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“…Aerosolized ribavirin was not used for safety reasons because of its suspected teratogenicity for the surroundings. 27 During ribavirin therapy, patients were checked twice weekly for signs of hemolytic anemia as the major reported side-effect. 28 In cases of significant hypogammaglobulinemia, patients might additionally receive polyvalent Ig preparations (0.2-0.4 g/kg body weight) at the discretion of the attending physician.…”

Section: Study Site Rsv Diagnostics and Treatmentmentioning

confidence: 99%

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

Lehners

Schnitzler

Geis

et al. 2013

Bone Marrow Transplant

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Respiratory syncytial virus (RSV) usually causes self-limiting upper respiratory tract infections, but can be associated with severe lower respiratory tract infection disease (LRTID) in infants and in patients with hematologic malignancies. We have analyzed the risk factors and the measures for containment within an outbreak of nosocomial RSV infections in a hematology and SCT unit. A total of 56 patients were affected (53 RSV-A and 3 RSV-B) including 32 transplant patients (16 allogeneic and 16 autologous). Forty (71%) of the 56 patients suffered from LRTID and 14 (35%) of the patients with LRTID subsequently died. However, because of concomitant infections with fungal and bacterial pathogens, the impact of RSV on the fatal outcome was difficult to assess. Multivariate analysis showed that low levels of IgG were significantly associated with fatal outcome (P ¼ 0.007), treatment with oral ribavirin represented a protective factor (P ¼ 0.02). An extremely protracted viral shedding was observed in this cohort of patients (median ¼ 30.5 days, range: 1-162 days), especially pronounced in patients after allogeneic transplantation (P ¼ 0.002). Implementation of rigorous isolation and barrier measures, although challenged by long-term viral carriers, was effective in containment of the outbreak.

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Section: Study Site Rsv Diagnostics and Treatmentmentioning

confidence: 99%

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

Lehners

Schnitzler

Geis

et al. 2013

Bone Marrow Transplant

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“…53 Scattered case reports have been published suggesting that the potential risk associated with ribavirin is overestimated, but these data are too limited to be convincing. 54,55 Alpha interferon is generally regarded as contraindicated in pregnancy.…”

Section: Issues Relating To Anti-viral Treatment For Chronic Hepatitimentioning

confidence: 99%

Maternal-infant transmission of hepatitis C virus infection

2002

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Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 10 6 copies per mL). M aternal and child health issues relating to hepatitis C virus (HCV) infection have recently assumed greater importance than ever before. From the pediatric perspective, the availability of effective screening methods for HCV has virtually eliminated new cases of transfusion-associated hepatitis C in children. Consequently, childhood acquisition of HCV infection through maternal-infant transmission has become the most important mode of spread. 1 Vertical, or more precisely, mother-to-infant hepatitis C will likely be the major type of childhood chronic hepatitis C within the next 6 to 8 years. It has been difficult to determine the rate of mother-to-infant transmission, partly because reports of mother-to-infant transmission of HCV have been based on small numbers of patients, with differing disease definitions, followed with different study designs and using different virological assays. These reports tended to be heterogeneous and conflicting. Moreover, factors that promote mother-to-infant transmission and the outcome of chronic HCV infection acquired by this route still require clarification. Likewise, for women of child-bearing age who acquired chronic hepatitis C in childhood or in early adulthood, there are important issues relating to pregnancy itself, such as its effect on the disease course of chronic hepatitis C. Prevalence of Hepatitis C Among Pregnant WomenNumerous studies have examined the prevalence of hepatitis C among pregnant women (Table 1). The studies vary considerably in terms of the size of the study, geographic variables, and adequacy of laboratory testing. In general, the prevalence of detectable antibody to HCV (anti-HCV) is approximately 1% overall (range, 0.1% to 2.4%), based on the studies that included at least 3,000 subjects. The mean Abbreviations: HCV, hepatitis C virus; anti-HCV, antibody to HCV; ALT, alanine aminotransferase; HIV, human immunodeficiency virus.

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“…The hazard/benefit ratio of ribavirin to health care workers and patients has been questioned, however (328)(329)(330)(331). The teratogenic effects of ribavirin in laboratory models (330,331) and its cardiovascular contraindications at therapeutic doses mean that a cumbersome scavenging ventilation system is required for every ribavirin aerosol tent that is used to treat an RSV-infected patient (332,333).…”

Section: Ribavirin As Treatment For Active Rsv Infectionmentioning

confidence: 99%

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

2017

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SUMMARY Respiratory syncytial virus (RSV) infection is a significant cause of hospitalization of children in North America and one of the leading causes of death of infants less than 1 year of age worldwide, second only to malaria. Despite its global impact on human health, there are relatively few therapeutic options available to prevent or treat RSV infection. Paradoxically, there is a very large volume of information that is constantly being refined on RSV replication, the mechanisms of RSV-induced pathology, and community transmission. Compounding the burden of acute RSV infections is the exacerbation of preexisting chronic airway diseases and the chronic sequelae of RSV infection. A mechanistic link is even starting to emerge between asthma and those who suffer severe RSV infection early in childhood. In this article, we discuss developments in the understanding of RSV replication, pathogenesis, diagnostics, and therapeutics. We attempt to reconcile the large body of information on RSV and why after many clinical trials there is still no efficacious RSV vaccine and few therapeutics.

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Congenital Anomalies Induced in Hamster Embryos with Ribavirin

Abstract: Ribavirin, when given to pregnant hamsters in relatively small single doses, induces congenital anomalies of limbs, ribs, eyes, and central nervous system, as well as fetal deaths. On the basis of these findings, caution should be used in giving ribavrin to women of child-bearing age.

Cited by 70 publications

References 6 publications

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

Maternal-infant transmission of hepatitis C virus infection

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

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