Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. National Institute of Allergy and Infectious Diseases collaborative antiviral study.
We evaluated adenine arabinoside (vidarabine) for treatment of herpes simplex encephalitis in a placebo-controlled study. In 28 cases proved by isolation of Type 1 virus from brain biopsy, treatment reduced mortality from 70 to 28 per cent (P = 0.03), and over 50 per cent of treated survivors had no or only moderately debilitating neurologic sequelae. This improvement was achieved without evidence of acute drug toxicity. Thus, adenine arabinoside has a good therapeutic index (efficacy/toxicity) for the treatment of Type 1 herpes simplex encephalitis. However, the drug must be given early in the course of infection before the advent of coma to have a beneficial effect. Moreover, it should be coupled with brain biopsy for specific diagnosis to avoid unnecessary treatment of nonresponsive encephalitides that can mimic herpes simplex.
D001706:Biopsy; D001921:Brain / Q000382:microbiology; D002986:Clinical Trials as Topic; D004341:Drug Evaluation; D004660:Encephalitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006561:Herpes Simplex / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D018139:Simplexvirus / Q000302:isolation & purification; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D014740:Vidarabine