Alcohol Consumption and Its Influence on the Clinical Picture of Puumala Hantavirus Infection.

Laura Tervo,Jaana Syrjänen,Jenna Mustalahti,Ilkka Pörsti,Onni Niemelä,Tuula K Outinen,Heini Huhtala,Jukka T Mustonen,Satu Mäkelä

doi:10.3390/v14030500

Abstract

Puumala hantavirus (PUUV) causes hemorrhagic fever with renal syndrome. Characteristic clinical findings include acute kidney injury (AKI), thrombocytopenia, and capillary leakage. Smoking increases the risk of severe AKI, but it is not known whether alcohol consumption predisposes patients to a more severe infection. Liver and pancreatic enzymes, as well as biomarkers of alcohol consumption (gamma-glutamyl transferase, GGT; carbohydrate-deficient transferrin, CDT; GGT-CDT combination; and ethyl glucuronide, EtG), were measured from 66 patients with acute PUUV infection during hospitalization and at the convalescence phase. Alcohol consumption was present in 41% of the study population, 15% showing signs of heavy drinking. Alcohol use did not affect the severity of PUUV induced AKI nor the overall clinical picture of the infection. Liver enzyme levels (GGT or alanine aminotransferase, ALT) were elevated in 64% of the patients, but the levels did not associate with the markers reflecting the severity of the disease. Serum amylase activities at the convalescent stage were higher than those at the acute phase (p < 0.001). No cases with acute pancreatitis were found. In conclusion, our findings indicate that alcohol consumption does not seem to affect the clinical course of an acute PUUV infection.

Highlights

Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome (HFRS)
Alcohol drinking was not found to show a significant relationship with the clinical course of Puumala hantavirus (PUUV) infection
Liver enzymes were commonly elevated in these patients, but they did not associate with the clinical outcome or kidney dysfunction

Summary

Introduction

Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome (HFRS). It is caused by Puumala hantavirus (PUUV), found in Europe and Russia [1]. The PUUV infection is carried by the bank vole (Myodes glareolus), and the infection is transmitted to humans by inhaling the aerosols of infected rodent excreta [2]. Other hantaviruses causing HFRS are Hantaan, Dobrava, and Seoul viruses [2]. The fatality rate of NE is low, ranging from 0.08% up to 0.4% [3,4]. The disease burden in Finland is considerable with the incidence of diagnosed PUUV infections of 31 to 39 cases per 100,000 inhabitants [5]. According to a recent nationwide study, a seroprevalence of 12.5% in the Finnish population was found [6]

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