MEDITERRANEAN JOURNAL OF INFECTION MICROBES AND ANTIMICROBIALS, vol.6, 2017 (ESCI)
Hantavirus is an enveloped virus with a RNA genome comprised of three negative-sense, single-stranded segments and belongs to the genus Hantavirus in family Bunyaviridae. Human infections are seen in two different clinical presentations: "hemorrhagic fever with renal syndrome" and "Hantavirus cardiopulmonary syndrome". However, the main pathogenetic mechanism is vascular endothelial dysfunction; viral properties and host immunogenetic factors both play a role in pathogenesis. Early diagnosis and supportive treatment have vital importance for the prevention of mortality. Fluid/electrolyte and oxygen therapy, renal replacement, and regulation of blood pressure are the main components of supportive treatment. Although ribavirin is controversial in the specific treatment, some studies have suggested its use during the oliguric phase of disease. Favipiravir and icatibant are other effective drugs in the treatment, and the use of alpha v beta 3 integrin inhibitors is also suggested. In recent years, monoclonal antibodies have been proposed not only for treatment of disease but also prophylaxis. DNA vaccines prepared with new technologies have good efficacy, enhancing the neutralizing antibody response. The next major breakthrough in Hantavirus immunization will be a vaccine that is effective against all viral subtypes.