Characteristics, management and outcome of Herpes Simplex and Varicella-Zoster virus encephalitis : a multicentre prospective cohort study
Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved..
OBJECTIVE: To characterize differences between Herpes Simplex virus encephalitis and Varicella-Zoster virus encephalitis (HSVE and VZVE) and other aetiologies of infectious encephalitis (IE), and to investigate the impact of time-to-aciclovir (ACV) start, ACV dose and duration on outcome.
METHODS: We compared 132 HSVE, 65 VZVE and 297 other IE enrolled in a prospective cohort (ENCEIF). We estimated associations between time-to-ACV start, dose or duration and outcome through adjusted odds ratio (aOR) using logistic regression analysis.
RESULTS: Prevalence of immunodepression differed among aetiologies: 15/65 (23%) for VZVE, 13/132 (10%) for HSVE and 30/297 (10%) for other IE (p <0.05), as was presence of seizure at admission: 27/132 (20%) for HSVE, 4/65 (6%) for VZVE and 43/297 (14%) for other IE (p <0.05). Poor outcome at hospital discharge (Glasgow outcome scale ≤3) differed among the three groups: 40/127 (31%) for HSVE, 12/65 (18%) for VZVE and 38/290 (13%) for other IE (p <0.05). Time-to-ACV start was associated with outcome in HSVE (aOR 3.61 [1.25-10.40]), but not in VZVE (aOR 0.84 [0.18-3.85]). Increased ACV dose was not associated with outcome among HSVE (aOR 1.25 [0.44-3.64]) nor VZVE (aOR 1.16 [0.24-5.73]).
DISCUSSION: HSVE and VZVE are distinct in clinical presentation, outcome and prognostic factors. The impact of early ACV initiation was more apparent for HSVE than for VZVE; however, this could be because of VZVE's smaller sample size and lower outcome rate leading to low statistical power or because of potential distinct IE pathophysiology.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - (2024) vom: 26. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Poussier, Léa [VerfasserIn] |
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| Links: |
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| Themen: |
Acyclovir |
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| Anmerkungen: |
Date Revised 19.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1016/j.cmi.2024.03.017 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370171721 |
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| 041 | |a eng | ||
| 100 | 1 | |a Poussier, Léa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Characteristics, management and outcome of Herpes Simplex and Varicella-Zoster virus encephalitis |b a multicentre prospective cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 19.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a OBJECTIVE: To characterize differences between Herpes Simplex virus encephalitis and Varicella-Zoster virus encephalitis (HSVE and VZVE) and other aetiologies of infectious encephalitis (IE), and to investigate the impact of time-to-aciclovir (ACV) start, ACV dose and duration on outcome | ||
| 520 | |a METHODS: We compared 132 HSVE, 65 VZVE and 297 other IE enrolled in a prospective cohort (ENCEIF). We estimated associations between time-to-ACV start, dose or duration and outcome through adjusted odds ratio (aOR) using logistic regression analysis | ||
| 520 | |a RESULTS: Prevalence of immunodepression differed among aetiologies: 15/65 (23%) for VZVE, 13/132 (10%) for HSVE and 30/297 (10%) for other IE (p <0.05), as was presence of seizure at admission: 27/132 (20%) for HSVE, 4/65 (6%) for VZVE and 43/297 (14%) for other IE (p <0.05). Poor outcome at hospital discharge (Glasgow outcome scale ≤3) differed among the three groups: 40/127 (31%) for HSVE, 12/65 (18%) for VZVE and 38/290 (13%) for other IE (p <0.05). Time-to-ACV start was associated with outcome in HSVE (aOR 3.61 [1.25-10.40]), but not in VZVE (aOR 0.84 [0.18-3.85]). Increased ACV dose was not associated with outcome among HSVE (aOR 1.25 [0.44-3.64]) nor VZVE (aOR 1.16 [0.24-5.73]) | ||
| 520 | |a DISCUSSION: HSVE and VZVE are distinct in clinical presentation, outcome and prognostic factors. The impact of early ACV initiation was more apparent for HSVE than for VZVE; however, this could be because of VZVE's smaller sample size and lower outcome rate leading to low statistical power or because of potential distinct IE pathophysiology | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acyclovir | |
| 650 | 4 | |a Herpes Simplex virus | |
| 650 | 4 | |a Infectious encephalitis | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Varicella-Zoster virus | |
| 700 | 1 | |a Mailles, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Tattevin, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Stahl, Jean-Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Fillâtre, Pierre |e verfasserin |4 aut | |
| 700 | 0 | |a scientific committee and investigators group |e verfasserin |4 aut | |
| 700 | 0 | |a investigators’ group are |e verfasserin |4 aut | |
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| 700 | 1 | |a Abgrall, Sophie |e investigator |4 oth | |
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| 700 | 1 | |a Baldolli, Aurélie |e investigator |4 oth | |
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| 700 | 1 | |a Biron, Charlotte |e investigator |4 oth | |
| 700 | 1 | |a Blanchet-Fourcade, Geneviève |e investigator |4 oth | |
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| 700 | 1 | |a Courjon, Johan |e investigator |4 oth | |
| 700 | 1 | |a De Broucker, Thomas |e investigator |4 oth | |
| 700 | 1 | |a De La Blanchardière, Arnaud |e investigator |4 oth | |
| 700 | 1 | |a de Montmollin, Etienne |e investigator |4 oth | |
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