Lassa Fever Insights: Epidemiology, Metabolism, Pharmacokinetics of Ribavirin, Mechanisms against Arenaviruses and its Novel Application in the Future
Oguh Collins Egwu
*
Department of Subnational, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria and Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Niger State, Nigeria.
Peter Kukeunim Ukeh
General Hospital Sabon Wuse, Niger State, Nigeria.
Zephaniah Jesse Cegbeyi
Berith Specialist Hospital, Kwamba, Suleja, Niger State, Nigeria.
Nkem Usha Eze-Ugbogulu
Swansea University Medical School, United Kingdom.
Oyigbo Gladys Nneka
Department of Zoology and Enviromental Biology, University of Nigeria Nsukka, Nigeria.
Mohamed Dumbuya
Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Niger State, Nigeria.
Chindo Ibrahim Bisallah
Africa Centre of Excellence for Mycotoxin and Food Safety, Federal University of Technology Minna, Niger State, Nigeria.
Michael Ochigbo Onyilo
Niger State Agency for the Control of AIDS, Nigeria.
Patrick Bidi Gimba
Public Health Department, Niger State Ministry of Tertiary and Secondary Health Care, Nigeria.
Jiya Samuel Ndagi
Office of the Director Disease Control and Immunization, Niger State Primary Health Care Development Agency, Nigeria.
Abbah Okpachi Christophere
Department of Subnational, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria.
Sebastian Yennan
Department of Subnational, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Lassa fever is an acute viral hemorrhagic fever illness caused by Lassa virus which is zoonotics, or animal-borne. The virus is a member of the arena virus family, which is an RNA single-stranded virus. Ribavirin therapy is use for treatment and the antiviral abilities of ribavirin have been explained by five different mechanisms. These include both direct (interference with RNA capping, polymerase inhibition, lethal mutagenesis) and indirect mechanisms (Inhibition of inosine monophosphate dehydrogenase and immunomodulatory effects). Ribavirin was the first synthetic nucleoside to display broad-spectrum antiviral activity and is one of the few antiviral medications currently being used in clinical settings that is effective against Lassa fever and other hemorrhagic diseases such as Ebola. Ribavirin has a long half-life resulting in more than 4 weeks to reach steady state ribavirin concentrations when administered orally in healthy individuals. This review aims at providing an overview of Lassa fever epidemiology, pharmacology and multiple modes of action of ribavirin as well as pointing to possible novel future uses.
Keywords: Arenaviruses, epidemiology, lassa fever, mechanisms, pharmacokinetic, ribavirin