Lassa Fever Insights: Epidemiology, Metabolism, Pharmacokinetics of Ribavirin, Mechanisms against Arenaviruses and its Novel Application in the Future

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.