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Cited by 27Herpesvirus Infections and TreatmentsCytomegalovirus and herpesvirus researchInfectious Encephalopathies and Encephalitis

Long-Term Survival, Morbidity, Social Functioning and Risk of Disability in Patients with a Herpes Simplex Virus Type 1 or Type 2 Central Nervous System Infection, Denmark, 2000–2016

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Hansen, Ann-Brit Eg, Vestergaard, Hanne, Dessau, Ram B, Bodilsen, Jacob, Andersen, Nanna S., Omland, Lars H, Christiansen, Claus B, Ellermann-Eriksen, Svend +6 more·2020·Clinical Epidemiology
DOI 10.2147/clep.s256838PMC PMC7371560
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Abstract

BACKGROUND: The long-term prognosis following herpes simplex virus (HSV) central nervous system (CNS) infection is still debated. PATIENTS AND METHODS: We examined outcomes in all Danish residents who, during 2000-2016, tested PCR positive for HSV-1 (n=208) or HSV-2 (n=283) in the cerebrospinal fluid, compared to comparison cohorts from the general population (n=2080 and n=2830). RESULTS: One-year mortality was increased among HSV-1 patients (difference 19.3%; 95% CI: 13.6% to 25.0%) and HSV-2 patients (difference 5.3%; 95% CI: 2.5% to 8.1%), but thereafter mortality was not increased. After exclusion of persons diagnosed with cancer prior to study inclusion, one-year mortality difference for HSV-2 patients was 1.7% (-0.1% to 3.5%). After five years, HSV-1 patients had lower employment (difference -19.8%; 95% CI: -34.7% to -4.8%) and higher disability pension rates (difference 22.2%; 95% CI: 8.4% to 36.0%) than the comparison cohort, but similar number of inpatient days, outpatient visits, and sick leave. HSV-2 patients had employment and disability pension rates comparable to the comparison cohort, but more inpatient days (difference 1.5/year; 95% CI: -0.2 to 3.2), outpatient visits (difference 1.3/year; 95% CI: 0.3 to 3.2), and sick leave days (difference 9.1/year; 95% CI: 7.9 to 10.4). CONCLUSION: HSV-1 and HSV-2 CNS infections differ substantially with respect to prognosis. HSV-1 CNS infection is followed by increased short-term mortality and long-term risk of disability. HSV-2 CNS infection has no substantial impact on mortality or working capability but is associated with increased morbidity.

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  • Short-term outcome after viral meningitis was frequently unfavourable but improved during extended follow up.

    “In agreement with most previous studies, we observed that short-term outcome after viral meningitis was frequently unfavourable but improved during extended follow up.6,21,22”

    From Clinical features and prognostic factors in adults with viral meningitis. (2023) · cites this paper as [21]

    The Discussion (page not provided) says HSV-2 CNS infection, which mainly presents as meningitis, may cause short-term neurological morbidity but generally has a benign long-term prognosis. It does not establish that short-term outcomes were frequently unfavourable, demonstrate improvement in individual patients over follow-up, or extend the finding to viral meningitis generally. (LLM, conf=0.83)

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Authors
Hansen, A.-B. E., Vestergaard, H., Dessau, R. B., Bodilsen, J., Andersen, N. S., Omland, L. H., Christiansen, C. B., Ellermann-Eriksen, S., Nielsen, L., Benfield, T., Sørensen, H. T., Andersen, C. Ø., Lebech, A.-M., & Obel, N.
Affiliations
  • University of Copenhagen (DK)
  • Statens Serum Institut (DK)
  • Slagelse Hospital (DK)
  • Aalborg University Hospital (DK)
  • Odense University Hospital (DK)
  • Copenhagen University Hospital (DK)
  • Aarhus University Hospital (DK)
Corresponding author
Hansen, Ann-Brit Eg
ORCID
Venue
Clinical Epidemiology
Publisher
Informa UK Limited
Published
2020-07
Volume
Volume 12
Pages
745-755
ISSN
1179-1349 (ISSN-L)
DOI
10.2147/clep.s256838
PMC
PMC7371560
OpenAlex
W3042463492
Cited by
27
References
31
Citations by year
2026: 3 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 4
FWCI
2.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Epidemiology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion, cc-by-nc)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by-nc)
Funders
Danmarks Frie Forskningsfond (6110-00173B)
Topics
  • Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
  • Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
herpes simplex virus type 1, herpes simplex virus type 2, central nervous system infection, herpes simplex encephalitis, long-term prognosis, mortality, disability pension, employment, social functioning, morbidity, sick leave, inpatient days, outpatient visits, cerebrospinal fluid PCR

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