Viral load in febrile phase rather than the duration of virus associates the severity of hemorrhagic fever with renal syndrome

Abstract Hemorrhagic fever with renal syndrome (HFRS) was Hantaviruses infectious disease with a mortality rate of 1-10%. In the previous studies, the duration of the virus and the relationship between the virus and the severity of the disease were still unclear. 137 patients with HFRS were enrolled in this study, patients were followed up every three days until the virus load was negative. Virus quantification was performed using RT-PCR method. Of all the 137 patients, 38 patients (28%) were classified as severe/critical cases. We found that the duration of the virus lasted much longer than we thought before. Most patients still have virus during the polyuria phase, and some patients even have virus in recovery phase. We confirmed that viral load in febrile phase rather than the duration of virus associated with the severity of Hantaan virus caused HFRS. This indicates that tissue damage in HFRS may not related to the virus, virus activated immune response in the early stages may responsible for the pathogenesis. Understanding the mechanism of virus in HFRS will provide ideas and guidance for better clinical treatment.