ACYCLOVIR VERSUS VIDARABINE IN HERPES SIMPLEX ENCEPHALITIS
Abstract
127 patients with suspected herpes simplex encephalitis (HSE) were entered in a prospective randomised study of acyclovir 10 mg/kg 8-hourly versus vidarabine 15 mg/kg daily for 10 days. The patients were consecutive and nearly all Swedish cases of HSE were included; they were treated in six university infectious diseases departments. The diagnosis of HSE was verified by brain biopsy and/or antibody responses in serum and cerebrospinal fluid. Of 53 confirmed cases of HSE (corresponding to 2 X 3 cases per million inhabitants per year in Sweden), 51 (27 acyclovir, 24 vidarabine) were evaluable for analysis of efficacy. The mortality was 19% in the acyclovir-treated group versus 50% in the vidarabine group (p = 0.04). At 6 months of observation 15 (56%) of 27 acyclovir-treated patients had returned to normal life compared with 3 (13%) of 24 vidarabine-treated patients (p = 0.002); and the numbers who died or had severe sequelae were 9 (33%) and 19 (76%), respectively (p = 0.005). No important or new adverse events were recognised.
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The advent of acyclovir in the late 1980s considerably modified the prognosis of HSV-1 encephalitis.
“The advent of acyclovir, in the late 1980s, considerably modified the prognosis of HSV-1 encephalitis [54–56].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [54]
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Self-citation
- Authors
- Sköldenberg, B., Alestig, K., Burman, L., Forkman, A., Lövgren, K., Norrby, R., Stiernstedt, G., Forsgren, M., Bergström, T., Dahlqvist, E., Frydén, A., Norlin, K., Olding-Stenkvist, I., Uhnoo, I., & De Vahl, K.
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1984-09
- Volume
- 324
- Issue
- 8405
- Pages
- 707-711
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2149507482
- Cited by
- 610
- References
- 26
- Citations by year
- 2026: 6 · 2025: 20 · 2024: 16 · 2023: 13 · 2022: 12 · 2021: 14 · 2020: 7 · 2019: 14 · 2018: 10 · 2017: 16 · 2016: 15 · 2015: 15 · 2014: 16 · 2013: 12 · 2012: 12
- FWCI
- 28.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Keywords
- herpes simplex encephalitis, acyclovir, vidarabine, antiviral therapy, drug efficacy comparison, mortality, functional outcome, adverse events, Sweden
- MeSH terms
- Acyclovir, Adolescent, Adult, Aged, Antibodies, Viral, Brain, Child, Child, Preschool, Clinical Trials as Topic, Double-Blind Method, Encephalitis, Follow-Up Studies, Herpes Simplex, Humans, Infant, Infant, Newborn, Middle Aged, Prospective Studies, Random Allocation, Vidarabine, Simplexvirus
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