Two Neuropsychiatric Cases Seropositive for Bornavirus Improved by Ribavirin

Abstract

A c c e p t e d M a n u s c r i p t While we had previously detected anti-bornavirus antibodies via radioligand assay in psychiatric patients, we had not examined the viral pathogenicity in these individuals.Herein, we present two psychiatric patients who were seropositive for bornavirus and whose treatment-resistant symptoms improved by oral administration of ribavirin, a broad-spectrum antiviral agent. Cerebrospinal fluid analysis indicated that the ribavirin affected the central nervous system of these patients. Ribavirin ameliorated intermittent involuntary head shaking, which is reminiscent of a symptom observed in bornavirus-infected animals. Using radioligand assays to examine the serial sera of these patients, we found a relationship between the titers of anti-bornavirus antibodies and the change in the patients' symptoms. Our findings suggest there is a relationship between bornavirus and human symptoms and that ribavirin may be useful in suppressing chronic bornavirus infection in some neuropsychiatric patients. However, the possibility remains that some other known or unknown virus other than bornavirus, which is sensitive to ribavirin, may have caused the symptoms. Additional evidence that directly indicates the causative relationship between bornavirus and human symptoms is needed before establishing the pathogenesis and treatment for human bornavirus infection. .

Ribavirin Treatment for Severe Schizophrenia with Anti-Borna Disease Virus 1 Antibodies 30 Years after Onset

“…The specific serum antibody levels at the end of the ribavirin administration were similar to those before treatment. However, in one previously reported case that was responsive to ribavirin, a decrease in antibody levels was observed 2 years after the end of treatment [ 23 ].…”

“…Although hemolytic anemia is a common side effect of ribavirin treatment and caution should be exercised given the risk of teratogenicity, it is unlikely to cause any other serious side effects. A previously reported clinical trial of oral ribavirin in seropositive patients with refractory neuropsychiatric symptoms showed clear improvement in two of nine patients [ 23 ]. Here, we report the case of a patient with a medical history of severe schizophrenia for more than 30 years who showed some improvement after ribavirin treatment.…”

A Small Interfering RNA Cocktail Targeting the Nucleoprotein and Large Protein Genes Suppresses Borna Disease Virus Infection

“…Additionally, although it is still controversial, several studies have reported potential human cases of bornavirus infection in various psychiatric disorders (Nakamura et al, 2000; Honda et al, 2017b, 2018). Indeed, there are a few human case reports showing remission of symptoms after treatment with antivirals against bornaviruses, although the causative relationship is unclear (Matsunaga et al, 2018). So far, ribavirin and T-705 (favipiravir) are nominated as antivirals against bornaviruses (Mizutani et al, 1998; Musser et al, 2015; Reuter et al, 2016; Tokunaga et al, 2017).…”