Archives of Virology

, Volume 164, Issue 2, pp 547–557 | Cite as

Factors related to fatalities and clinical progression of Crimean-Congo hemorrhagic fever patients and the effects of IL 28-B gene polymorphism

  • Feyza Yıldız AytekinEmail author
  • Hüseyin Şener Barut
  • Aydın Rüstemoğlu
  • Ayfer Atay
  • Özgür Günal
  • Fazilet Duygu
Original Article


Mortality rates of Crimean-Congo hemorrhagic fever (CCHF) vary from 5% to 80%. However, there is no clear information available about why this disease is fatal for some people while others recover. In this study, the factors related to fatalities and serious clinical progression of CCHF patients and the correlation between serious prognosis and IL 28-B gene polymorphism were investigated. The study included 107 patients with a preliminary diagnosis of CCHF, and the patients were found positive for CCHFV RNA based on polymerase chain reaction (PCR) analysis. The IL 28-B rs12979860 polymorphism was identified by PCR “restriction fragment length polymorphism” (PCR-RFLP) analysis using blood samples from the patients. In addition to the IL 28-B analysis results, a variety of data along with laboratory records obtained during the hospital stay were evaluated using statistical analysis. Of the 107 cases, nine were fatal (8.4%), while the other patients recovered and were discharged. Twenty-four patients had the CC genotype (22.43%), 64 had the CT genotype (59.81%), and 19 had the TT genotype (17.76%). Of the nine patients who died, three had the CC genotype (33.33%) and six had the CT genotype (66.67%). None of the patients who died had the TT genotype. Symptoms and findings of diarrhea, abdominal pain, hemorrhage, and rash were more common in fatal cases than in non-fatal cases. The IL 28-B rs12979860 polymorphism was not found to have a statistically significant correlation with fatality or symptoms indicating serious clinical progression in CCHF patients. As has been observed in previous studies, our study showed that leukocytosis, abdominal pain and diarrhea were more common in fatal cases.


Author contributions

FYA: writing, data collection. HŞB: materials and methods, revision. AR: materials and methods, genetic experiments, revision. AA: data collection. ÖG: writing, data collection, materials and methods. FD: writing, data collection, materials and methods.


Materials used for genetic analysis were obtained from the medical biology laboratory. Blood values evaluated in the study were the results of routine diagnosis/treatment.

Compliance with ethical standards

Ethical approval

This study was evaluated by the Gaziosmanpaşa University Faculty of Medicine Research and Application Hospital Clinic Ethics Committee on 24/09/2013 at meeting 18, and permission was granted with decision 371, dated 01/11/2013.

Human/animal rights statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Availability of data and material

The datasets used and/or analyzed in the current study are available from the corresponding author on reasonable request.

Conflict of interest

The authors declare that there is no conflict of interest of any type, that no financial disclosure information is relevant, and that they take full responsibility for this publication’s results and their interpretations.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Feyza Yıldız Aytekin
    • 1
    Email author
  • Hüseyin Şener Barut
    • 2
  • Aydın Rüstemoğlu
    • 3
  • Ayfer Atay
    • 4
  • Özgür Günal
    • 5
  • Fazilet Duygu
    • 6
  1. 1.Department of Infectious Diseases and Clinical MicrobiologyMinistry of Health-Giresun University Prof. Dr. A. Ilhan Özdemir Training and Research HospitalGiresunTurkey
  2. 2.Department of Infectious Diseases and Clinical Microbiology, Faculty of MedicineGaziosmanpasa UniversityTokatTurkey
  3. 3.Department of Medical Biology, Faculty of MedicineGaziosmanpasa UniversityTokatTurkey
  4. 4.Department of Infectious Diseases and Clinical MicrobiologyBahçelievler State HospitalIstanbulTurkey
  5. 5.Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research HospitalUniversity of Health ScienceSamsunTurkey
  6. 6.Department of Infectious Diseases and Clinical Microbiology, Ankara Onkology Training and Research HospitalUniversity of Health ScienceAnkaraTurkey

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