Hantavirus Infection: Review of Clinical Management

Hantavirus infection is a rodent-borne zoonotic disease that can present as Hemorrhagic Fever with Renal Syndrome (HFRS) or Hantavirus Cardiopulmonary Syndrome (HCPS). Both diseases are associated with substantial morbidity and mortality. The rise of new Hantavirus species and recurrent outbreaks worldwide has renewed interest in the epidemiology, pathogenesis, diagnosis, and management of this viral infection. A narrative literature review was conducted using published articles, review papers, epidemiological reports, and clinical studies on Hantavirus up to 2026. Relevant evidence regarding epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, treatment, complications, and prevention was analyzed and synthesized. Hantaviruses primarily infect endothelial cells, leading to increased vascular permeability, thrombocytopenia, and capillary leakage through immune-mediated mechanisms. HFRS affects the kidneys, and HCPS is characterized by severe cardiopulmonary symptoms, although overlap between the two syndromes has increasingly been observed. Diagnosis is based on clinical suspicion supported by epidemiological exposure history, serological testing, and virological confirmation from reverse transcription polymerase chain reaction (RT-PCR). Current management remains largely supportive, including hemodynamic stabilization, respiratory support, and renal replacement therapy when indicated. Ribavirin may provide benefit in selected HFRS cases when given early, but evidence remains inconclusive, especially for HCPS. Favipiravir has demonstrated promising antiviral activity in vitro and in animal studies, yet clinical data in humans are still lacking. Preventive measures focus primarily on minimizing exposure to infected rodents and contaminated environments, while vaccine development remains ongoing. Hantavirus infection continues to represent an important global public health concern due to its potential for severe disease and high mortality. Improved understanding of disease pathogenesis, advances in diagnostic methods, and ongoing research into antiviral therapies and vaccines are essential to improve patient outcomes and strengthen future prevention strategies.