Effectiveness of the ribavirin in treatment of hantavirus infections in the Americas and Eurasia: a meta-analysis.

Hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS) are transmitted to humans through infection with the old- and new-world hantaviruses, respectively. Together these diseases affect tens of thousands of people every year, and no specific treatment is available. To investigate whether ribavirin treatment for hantaviruses infections decreases disease severity, we conducted a meta-analysis involving human and animal studies. After defining the research protocol and criteria for inclusion/exclusion, we identified seven studies. We found that in groups with HPS who were treated with ribavirin, there was no significant reduction in mortality (RR 0.99, 95 % CI 0.60-1.61, I(2) = 0 %). On the other hand, for animal group with HPS-like disease, there was significant increase in survival (RR 0.05, 95 % CI 0.01-0.34, I(2) = 0 %). For animal group infected with the old-world hantaviruses, treated with ribavirin, there was a statistically significant increase in survival (RR 0.56, 95 % CI 0.42-0.76, I(2) = 64 %). Similarly, for humans with HFRS treated, there was increase in survival (RR 0.28, 95 % CI 0.08-1), although only a study exist. Our meta-analysis provides data that should be interpreted with caution, partly due to the limited number of studies available. Additionally, the results of the application of ribavirin in the population with HPS could not be determined, particularly in patients in the end stage of this disease.