Viral load as a predictor of outcome in Crimean-Congo hemorrhagic fever

Clin Infect Dis. 2007 Oct 1;45(7):e96-100. doi: 10.1086/521244. Epub 2007 Aug 23.


Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal disease affecting multiple organ systems. To determine the association between viral load and severity of CCHF infection, quantitative measurement of CCHF virus was performed using 1-step reverse-transcriptase polymerase chain reaction for 36 patients with CCHF infection. Viral loads ranged from 1.1x10(3) copies/mL to > or = 9.9x10(9) copies/mL. Nine (25%) of 36 patients died. In 8 of the 9 patients with fatal outcomes, viral loads were detected that were > or = 1x10(9) copies/mL, whereas in 25 of the 26 patients with nonfatal outcomes, viral loads were detected that were < 1x10(9) copies/mL (P<.001). A viral load > or = 1x10(9) RNA copies/mL can be considered to predict a fatal outcome with a positive predictive value of 80%, with 88.9% sensitivity and 92.6% specificity. We suggest that viral load is a measure of the severity of CCHF.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Female
  • Hemorrhagic Fever Virus, Crimean-Congo / genetics
  • Hemorrhagic Fever Virus, Crimean-Congo / pathogenicity*
  • Hemorrhagic Fever, Crimean / blood*
  • Hospitals, Teaching
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • Severity of Illness Index
  • Turkey
  • Viral Load*


  • Biomarkers