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Long-term valacyclo...
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Aurelius, EKarolinska Institutet
(författare)
Long-term valacyclovir suppressive treatment after herpes simplex virus type 2 meningitis: a double-blind, randomized controlled trial.
- Artikel/kapitelEngelska2012
Förlag, utgivningsår, omfång ...
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2012-03-28
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Oxford University Press (OUP),2012
Nummerbeteckningar
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LIBRIS-ID:oai:gup.ub.gu.se/246552
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https://gup.ub.gu.se/publication/246552URI
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https://doi.org/10.1093/cid/cis031DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:124383124URI
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Klassifikation
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Herpes simplex virus type 2 (HSV-2) is a common cause of acute and recurrent aseptic meningitis. Our aim was to determine the impact of antiviral suppression on recurrence of meningitis and to delineate the full spectrum of neurological complications.One hundred and one patients with acute primary or recurrent HSV-2 meningitis were assigned to placebo (n = 51) or 0.5 g of valacyclovir twice daily (n = 50) for 1 year after initial treatment with 1 g of valacyclovir 3 times daily for 1 week in a prospective, placebo-controlled, multicenter trial. The primary outcome was time until recurrence of meningitis. The patients were followed up for 2 years.The first year, no significant difference was found between the valacyclovir and placebo groups. The second year, without study drugs, the risk of recurrence of verified and probable HSV-2 meningitis was significantly higher among patients exposed to valacyclovir (hazard ratio, 3.29 [95% confidence interval, 10.06-10.21]). One-third of the patients experienced 1-4 meningitis episodes during the study period. A considerable morbidity rate, comprising symptoms from the central, peripheral, and autonomous nervous system, was found in both groups.Suppressive treatment with 0.5 g of valacyclovir twice daily was not shown to prohibit recurrent meningitis and cannot be recommended for this purpose after HSV meningitis in general. Protection against mucocutaneous lesions was observed, but the dosage was probably inappropriate for the prevention of HSV activation in the central nervous system. The higher frequency of meningitis, after cessation of active drug, could be interpreted as a rebound phenomenon.
Ämnesord och genrebeteckningar
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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
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MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
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Acyclovir
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administration & dosage
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analogs & derivatives
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therapeutic use
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Adult
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Antiviral Agents
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administration & dosage
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therapeutic use
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Double-Blind Method
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Female
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Follow-Up Studies
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Herpes Simplex
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drug therapy
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prevention & control
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virology
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Herpesvirus 2
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Human
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drug effects
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Humans
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Male
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Meningitis
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Viral
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drug therapy
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prevention & control
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virology
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Prospective Studies
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Secondary Prevention
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Sweden
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Treatment Outcome
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Valine
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administration & dosage
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analogs & derivatives
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therapeutic use
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Franzen-Röhl, EKarolinska Institutet
(författare)
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Glimåker, M
(författare)
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Akre, OKarolinska Institutet
(författare)
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Grillner, LKarolinska Institutet
(författare)
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Jorup-Rönström, C
(författare)
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Studahl, Marie,1957Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine(Swepub:gu)xstuma
(författare)
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Karolinska InstitutetInstitutionen för biomedicin, avdelningen för infektionssjukdomar
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Clinical infectious diseases : an official publication of the Infectious Diseases Society of America: Oxford University Press (OUP)54:9, s. 1304-131537-6591
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Ingår i:Clinical Infectious Diseases: Oxford University Press (OUP)54:9, s. 1304-131058-4838
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