title: Interferon alfa-2a in Japanese encephalitis: a randomised double-blind placebo-controlled trial.
abstract: BACKGROUND
  Japanese encephalitis virus (JEV), although confined to Asia, causes about 35000-50000 cases and 10000 deaths every year, and is the most important cause of encephalitis worldwide. There is no known antiviral treatment for any flavivirus. Results from in-vitro studies and work in animals have shown inteferon alfa has antiviral activity on Japanese encephalitis and other flaviviruses; therefore, we aimed to assess the efficacy of inteferon alfa-2a in Japanese encephalitis.
  
  
  METHODS
  We did a randomised double-blind placebo-controlled trial of interferon alfa-2a (10 million units/m2, daily for 7 days) in 112 Vietnamese children with suspected Japanese encephalitis, 87 of whom had serologically confirmed infections. Our primary endpoints were hospital death or severe sequelae at discharge. Analysis was by intention to treat.
  
  
  RESULTS
  Overall, 21 children (19%) died, and 17 (15%) had severe sequelae. Outcome at discharge and 3 months did not differ between the two treatment groups; 20 children in the interferon group had a poor outcome (death or severe sequelae), compared with 18 in the placebo group (p=0.85, difference 0.1%, 95% CI -17.5 to 17.6%), there were no long-term side effects of interferon.
  
  
  CONCLUSIONS
  The doses of interferon alfa-2a given in this regimen did not improve the outcome of patients with Japanese encephalitis.
authors.affiliation: Department of Neurological Science, University of Liverpool, Walton Centre for Neurology and Neurosurgery, Liverpool, UK. tsolomon@liv.ac.uk
authors.forename: Tom
authors.initials: T
authors.lastname: Solomon
authors.forename: Nguyen Minh
authors.initials: NM
authors.lastname: Dung
authors.forename: Bridget
authors.initials: B
authors.lastname: Wills
authors.forename: Rachel
authors.initials: R
authors.lastname: Kneen
authors.forename: Mary
authors.initials: M
authors.lastname: Gainsborough
authors.forename: Tran Vinh
authors.initials: TV
authors.lastname: Diet
authors.forename: Tran Thi Nhu
authors.initials: TT
authors.lastname: Thuy
authors.forename: Ha Thi
authors.initials: HT
authors.lastname: Loan
authors.forename: Vo Cong
authors.initials: VC
authors.lastname: Khanh
authors.forename: David W
authors.initials: DW
authors.lastname: Vaughn
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004672:Encephalitis, Japanese / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D011994:Recombinant Proteins; D017211:Treatment Failure; D014744:Vietnam
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins