The researchers’ hypothesis, published by The Lancet, suggests that, although chemotherapy for avian influenza is a substantial jump in thinking, the notion of using such therapy could still be reasonable, particularly since it has shown efficacy in haemophagocytic lymphohistiocytosis disease (HLH), which may be associated with severe Epstein-Barr infection.
In their hypothesis, professor Jan-Inge Henter at the Karolinska Institutet in Stockholm and colleagues in Hong Kong state that patients with H5N1 infection have some symptoms and post-mortem features in common with people with the immune disorder HLH. Patients with HLH have too many infection-fighting white blood cells, which can accumulate in good tissue and cause damage to a variety of organs. One of the key treatments for HLH is the chemotherapy drug etoposide, which helps kill the excess of immune cells.
The scientists have emphasized that their suggestion is merely is a hypothesis at present, and that the treatment not yet has been tested in patients affected by avian influenza infection.
The researchers said that they would welcome the WHO considering a platform for the undertaking of clinical trials based on a modified HLH protocol, including etoposide and corticosteroids, in addition to supportive and antiviral therapy for patients infected by H5N1.