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Herpes Simplex Ence...
Herpes Simplex Encephalitis: Lack of Clinical Benefit of Long-term Valacyclovir Therapy
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Gnann, J. W. (author)
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Skoldenberg, B. (author)
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Hart, J. (author)
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- Aurelius, E. (author)
- Karolinska Institutet
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- Schliamser, Silvia (author)
- Lund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Studahl, Marie, 1957 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine
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- Eriksson, Britt-Marie (author)
- Uppsala universitet,Infektionssjukdomar
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Hanley, D. (author)
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Aoki, F. (author)
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- Ahlm, Clas (author)
- Umeå universitet,Institutionen för klinisk mikrobiologi
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Griffiths, P. (author)
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Miedzinski, L. (author)
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Hanfelt-Goade, D. (author)
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Hinthorn, D. (author)
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Ahlm, C. (author)
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Aksamit, A. (author)
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Cruz-Flores, S. (author)
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Dale, I. (author)
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Cloud, G. (author)
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Jester, P. (author)
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Whitley, R. J. (author)
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Jackson, Alan C (author)
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(creator_code:org_t)
- 2015-05-08
- 2015
- English.
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In: Clinical Infectious Diseases. - : Oxford University Press (OUP). - 1058-4838 .- 1537-6591. ; 61:5, s. 683-691
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Abstract
Subject headings
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- Background. Despite the proven efficacy of acyclovir (ACV) therapy, herpes simplex encephalitis (HSE) continues to cause substantial morbidity and mortality. Among patients with HSE treated with ACV, the mortality rate is approximately 14%-19%. Among survivors, 45%-60% have neuropsychological sequelae at 1 year. Thus, improving therapeutic approaches to HSE remains a high priority. Methods. Following completion of a standard course of intravenous ACV, 87 adult patients with HSE (confirmed by positive polymerase chain reaction [PCR] for herpes simplex virus DNA in cerebrospinal fluid) were randomized to receive either valacyclovir (VACV) 2 g thrice daily (n = 40) or placebo tablets (n = 47) for 90 days (12 tablets of study medication daily). The primary endpoint was survival with no or mild neuropsychological impairment at 12 months, as measured by the Mattis Dementia Rating Scale (MDRS). Logistic regression was utilized to assess factors related to the primary endpoint. Results. The demographic characteristics of the 2 randomization groups were statistically similar with no significant differences in age, sex, or race. At 12 months, there was no significant difference in the MDRS scoring for VACV-treated vs placebo recipients, with 85.7% and 90.2%, respectively, of patients demonstrating no or mild neuropsychological impairment (P = .72). No significant study-related adverse events were encountered in either treatment group. Conclusions. Following standard treatment with intravenous ACV for PCR-confirmed HSE, an additional 3-month course of oral VACV therapy did not provide added benefit as measured by neuropsychological testing 12 months later in a population of relatively high-functioning survivors.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
Keyword
- herpes simplex virus
- encephalitis
- antiviral therapy
- valacyclovir
- acyclovir
- polymerase-chain-reaction
- central-nervous-system
- virus-encephalitis
- cerebrospinal-fluid
- adult patients
- combination therapy
- acyclovir
- therapy
- diagnosis
- multicenter
- management
- Immunology
- Infectious Diseases
- Microbiology
- herpes simplex virus
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Gnann, J. W.
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Skoldenberg, B.
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Hart, J.
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Aurelius, E.
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Schliamser, Silv ...
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Studahl, Marie, ...
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show more...
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Eriksson, Britt- ...
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Hanley, D.
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Aoki, F.
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Ahlm, Clas
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Griffiths, P.
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Miedzinski, L.
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Hanfelt-Goade, D ...
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Hinthorn, D.
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Ahlm, C.
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Aksamit, A.
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Cruz-Flores, S.
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Dale, I.
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Cloud, G.
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Jester, P.
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Whitley, R. J.
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Jackson, Alan C
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Immunology in th ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Microbiology in ...
- Articles in the publication
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Clinical Infecti ...
- By the university
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University of Gothenburg
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Lund University
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Umeå University
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Karolinska Institutet
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Uppsala University