Therapy of focal viral encephalitis in children with aciclovir and recombinant beta-interferon - results of a placebo-controlled multicenter study.
Focal viral encephalitis in childhood is a rare but life-threatening disease. Animal experiments and case reports suggest a positive effect of an additional therapy with interferon-beta on the course of the disease. Therefore, we initiated a prospective, double-blind placebo-controlled study to investigate the benefit of a combination therapy of Aciclovir (ACV) and recombinant interferon-beta (rIFN-beta) in juvenile focal viral encephalitis. - Initial inclusion criterium was suspicion of focal viral encephalitis. Diagnosis was proven by demonstration of characteristic focal lesions in cerebral imaging or virological evidence of HSV in cerebrospinal fluid. Patients were treated with ACV plus rIFN-beta or ACV plus placebo. Neurological outcome was determined 21 days and 3 months after onset of the disease. - Initially 59 patients were enrolled in the study. Encephalitis was proven in 14 patients (7 ACV + rIFN-beta, 7 ACV + placebo). The study groups were balanced in terms of important prognostic criteria. 10 patients (5 ACV + rIFN-beta, 5 ACV + placebo) were cured or had slight defects, 4 patients (2 ACV + rIFN-beta, 2 ACV + placebo) showed moderate to severe defects. There was no significant difference in favour of the additive therapy with rIFN-beta.
Wintergerst
Uwe
U
University of Munich, Children's Hopital, Germany. uwe.wintergerst@med.uni-muenchen.de
Kugler
K
K
Harms
F
F
Belohradsky
B H
BH
Pfluger
T
T
D000212:Acyclovir / Q000627:therapeutic use*; D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D018792:Encephalitis, Viral / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005490:Focal Infection / Q000188:drug therapy* / Q000473:pathology; D006561:Herpes Simplex / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D016899:Interferon-beta / Q000627:therapeutic use*; D008297:Male; D009420:Nervous System / Q000473:pathology / Q000503:physiopathology; D011994:Recombinant Proteins / Q000627:therapeutic use; D020127:Recovery of Function / Q000187:drug effects; D016896:Treatment Outcome
D000998:Antiviral Agents; D011994:Recombinant Proteins; D016899:Interferon-beta; D000212:Acyclovir