Najioullah F, Bosshard S, Thouvenot D, Boibieux A, Menager B, Biron F, Aymard M, Lina B
Laboratoire de Virologie, Domaine Rockefeller, Lyon, France.
J Med Virol. 2000 Aug;61(4):468-73. doi: 10.1002/1096-9071(200008)61:4<468::aid-jmv9>3.0.co;2-9.
Herpes simplex viruses (HSV) are responsible for neurological disorders that require rapid diagnostic methods and specific antiviral therapy. During 1997, 1431 cerebrospinal fluid samples (CSF) collected from 1339 patients with neurological disorder presentations were processed for HSV detection. Eleven patients were positive for HSV, seven presenting with encephalitis (6/7 due to HSV1) and 4 with aseptic meningitis (4/4 due to HSV2). The incidence of HSV encephalitis was 2.33 cases / 10(6) inhabitants/year. Among encephalitis (HSV encephalitis) cases, 1 patient died due to the late implementation of antiviral therapy, and sequelae were observed in 4 cases. No sequelae were observed in aseptic meningitis cases. Four HSV encephalitis cases were monitored by PCR detection in CSF. Despite acyclovir therapy, PCR remained positive in CSF up to 20 days in 2 cases. This result suggest that the antiviral treatment for HSV encephalitis should be monitored by PCR detection of HSV in CSF.
单纯疱疹病毒（HSV）可引发需要快速诊断方法和特定抗病毒治疗的神经系统疾病。1997年期间，对从1339例有神经系统疾病表现的患者采集的1431份脑脊液样本（CSF）进行了HSV检测处理。11例患者HSV呈阳性，7例为脑炎（6/7由HSV1引起），4例为无菌性脑膜炎（4/4由HSV2引起）。HSV脑炎的发病率为2.33例/10⁶居民/年。在脑炎（HSV脑炎）病例中，1例患者因抗病毒治疗实施延迟而死亡，4例出现后遗症。无菌性脑膜炎病例未观察到后遗症。对4例HSV脑炎病例通过CSF中的PCR检测进行监测。尽管使用了阿昔洛韦治疗，但2例患者的CSF中PCR在长达20天内仍呈阳性。这一结果表明，HSV脑炎的抗病毒治疗应通过CSF中HSV的PCR检测进行监测。
