Montano S M, Mori N, Nelson C A, Ton T G N, Celis V, Ticona E, Sihuincha M, Tilley D H, Kochel T, Zunt J R
US Naval Medical Research Unit-6,Callao,Peru.
Fogarty International Center,National Institutes of Health,Bethesda,MD,USA.
Epidemiol Infect. 2016 Jun;144(8):1673-8. doi: 10.1017/S0950268815003222. Epub 2016 Jan 6.
Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru.
单纯疱疹病毒（HSV）是北美和欧洲最常见的脑炎感染病因之一。然而，这些地区以外的脑炎流行病学情况尚不明确。在2009年至2012年期间，我们在秘鲁对313名患者进行了一项多中心前瞻性脑炎研究，其中45名（14.4%）确诊为HSV感染。在38名已知HSV类型的患者中，84%感染的是HSV-1，16%感染的是HSV-2。与未感染HSV的患者相比，HSV感染患者在夏季发病的可能性显著更高（44.4%对20.0%，P = 0.003），且更易出现恶心（60.0%对39.8%，P = 0.01）和皮疹（15.6%对5.3%，P = 0.01）。这些发现凸显了北半球以外地区HSV脑炎在流行病学和临床表现上的差异，值得进一步研究。此外，秘鲁迫切需要提高HSV诊断能力并增加静脉注射阿昔洛韦的可及性。
