Rozenberg Flore
Service de Virologie Hôpital Cochin Bâtiment Jean-Dausset 27, rue du Faubourd Saint-Jacques 75679 Paris cedex 14.
Virologie (Montrouge). 2020 Oct 1;24(5):283-294. doi: 10.1684/vir.2020.0862.
Central nervous system (CNS) infections caused by herpes simplex viruses 1 (HSV-1) and 2 (HSV-2) greatly vary in frequency and severity. HSV-1 causes mostly herpes simplex encephalitis (HSE) which represents 5% to 15% of infectious encephalitis in children and adults. Despite available molecular diagnosis tools and antiviral drugs, the prognosis of HSE remains unacceptably low. In addition to mortality and immediate sequelae, auto-immune encephalitis (AIE) may occur, associated with the development of anti-neuronal antibodies in 1/4 of cases. Replicative relapses have been associated in few cases with genetic defects altering the innate immune response of neuronal cells. Herpetic meningitis is frequent, mostly associated with HSV-2 and genital herpes, sometimes recurrent and, mostly benign, except in immunocompromised individuals. Finally, exceptional cases of myelitis have been reported, due to ascending propagation of HSV-2 in the CNS. This review does not include neonatal infections.
由单纯疱疹病毒1型（HSV-1）和2型（HSV-2）引起的中枢神经系统（CNS）感染在发病率和严重程度上有很大差异。HSV-1主要引起单纯疱疹病毒性脑炎（HSE），占儿童和成人感染性脑炎的5%至15%。尽管有可用的分子诊断工具和抗病毒药物，但HSE的预后仍然低得令人难以接受。除了死亡率和即时后遗症外，自身免疫性脑炎（AIE）可能会发生，在四分之一的病例中与抗神经元抗体的产生有关。在少数情况下，复制性复发与改变神经元细胞固有免疫反应的基因缺陷有关。疱疹性脑膜炎很常见，主要与HSV-2和生殖器疱疹有关，有时会复发，并且大多是良性的，但免疫功能低下的个体除外。最后，有报告称出现了罕见的脊髓炎病例，这是由于HSV-2在中枢神经系统中上行传播所致。本综述不包括新生儿感染。
