Abstract |
Herpes simplex encephalitis is a devastating disease. In the early 1980s our group conducted a nationwide clinical trial of acyclovir versus vidarabine in patients with herpes simplex encephalitis in whom intrathecal herpes simplex virus (HSV) antibodies were assayed. The purpose of this study was to investigate if antibody levels and viral load correlate with outcome in herpes simplex encephalitis. We have analysed the prognostic value of HSV antibody levels in serum and cerebrospinal fluid (CSF) at the start of antiviral treatment in the 53 included patients. Frozen samples from a subset of patients were analysed with quantitative polymerase chain reaction (PCR) to assess the prognostic value of the viral load in CSF. IgG-levels in CSF at presentation were significantly higher in vidarabine-treated patients with a favourable outcome than in those treated with vidarabine but with an unfavourable outcome. The intrathecal viral load at presentation showed no correlation with outcome. However, the duration of positive HSV-PCR in CSF was longer in vidarabine-treated than in acyclovir-treated patients. These findings indicate that the B-cell response is important in the pathogenetic process of herpes simplex encephalitis. However, neither antibody levels nor viral load at presentation are useful as prognostic markers for the individual patient in this study.
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Authors | Anders Hjalmarsson, Fredrik Granath, Marianne Forsgren, Maria Brytting, Paul Blomqvist, Birgit Sköldenberg |
Journal | Journal of neurology
(J Neurol)
Vol. 256
Issue 8
Pg. 1243-51
(Aug 2009)
ISSN: 1432-1459 [Electronic] Germany |
PMID | 19353228
(Publication Type: Journal Article)
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Chemical References |
- Antibodies, Viral
- Antiviral Agents
- DNA, Viral
- Immunoglobulin G
- Vidarabine
- Acyclovir
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Topics |
- Acyclovir
(pharmacology, therapeutic use)
- Adolescent
- Adult
- Aged
- Antibodies, Viral
(analysis, blood, cerebrospinal fluid)
- Antibody Formation
(immunology)
- Antiviral Agents
(therapeutic use)
- B-Lymphocytes
(immunology, virology)
- DNA, Viral
(analysis)
- Encephalitis, Herpes Simplex
(drug therapy, immunology, virology)
- Female
- Humans
- Immunoglobulin G
(analysis, blood, cerebrospinal fluid)
- Male
- Microbial Sensitivity Tests
(methods)
- Middle Aged
- Polymerase Chain Reaction
(methods)
- Predictive Value of Tests
- Prognosis
- Time Factors
- Treatment Outcome
- Vidarabine
(pharmacology, therapeutic use)
- Viral Load
- Young Adult
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