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单纯疱疹病毒性脑炎和脑膜炎的全球患病率：一项系统评价和荟萃分析。

The Worldwide Prevalence of Herpes Simplex Virus Encephalitis and Meningitis: A Systematic Review and Meta-Analysis.

作者信息

Rohani Hoorieh, Arjmand Reza, Mozhgani Sayed-Hamidreza, Shafiee Arman, Amini Mohammad Javad, Forghani-Ramandi Mohammad-Moien

机构信息

Student Research Committee, Alborz University of Medical Sciences Faculty of Medicine, Karaj, Iran.

Department of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Alborz, Karaj, Iran.

出版信息

Turk Arch Pediatr. 2023 Nov;58(6):580-587. doi: 10.5152/TurkArchPediatr.2023.23007.

DOI:10.5152/TurkArchPediatr.2023.23007
PMID:37553966
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10724770/
Abstract

Given the relatively high frequency of central nervous system infections and considerable mor- tality and morbidity reported to be caused by herpes simplex viruses among the other viral agents, having a clear knowledge about their epidemiological profile seems necessary. This systematic review and meta-analysis aimed to determine the relative frequency and preva- lence of herpes simplex encephalitis and meningitis in patients tested for viral etiologies. A comprehensive systematic review was performed in PubMed, Scopus, and Web of Science databases, searching for studies on the prevalence and relative frequency of herpes sim- plex virus 1 and herpes simplex virus 2 encephalitis and meningitis. Seventy-one studies were included. Overall, the prevalence of herpes simplex virus encephalitis among patients tested was 8% (95% confidence interval, 6%-11%; I2 = 98%) and the prevalence of herpes simplex virus meningitis among aseptic patients tested was 4% (95% confidence interval, 3%-7%; I2 = 95%), and a significant difference was observed by region. The results of our subgroup analysis for herpes simplex virus encephalitis revealed a prevalence of 8% for pediatric patients and ado- lescents and 12% for adults. The results for herpes simplex virus meningitis showed a prevalence of 4% for pediatric patients and adolescents and 9% for adults. We observed significant differ- ences in the frequency of herpes simplex virus 1 and herpes simplex virus 2 detection rates by region. Having high rates of missed cases due to inadequate, highly sensitive paraclinical tests performed on patients with suspected viral central nervous system infection is one of the pos- sible factors. More studies are needed to detect the possible flaws in the process of diagnosis in different regions.

摘要

鉴于中枢神经系统感染的相对高发性，以及据报道单纯疱疹病毒在其他病毒病原体中导致的相当高的死亡率和发病率，清楚了解其流行病学概况似乎很有必要。本系统评价和荟萃分析旨在确定接受病毒病因检测的患者中单纯疱疹性脑炎和脑膜炎的相对频率和患病率。在PubMed、Scopus和Web of Science数据库中进行了全面的系统评价，搜索关于单纯疱疹病毒1型和单纯疱疹病毒2型脑炎及脑膜炎患病率和相对频率的研究。纳入了71项研究。总体而言，接受检测的患者中单纯疱疹病毒脑炎的患病率为8%（95%置信区间，6%-11%；I² = 98%），接受无菌检测的患者中单纯疱疹病毒脑膜炎的患病率为4%（95%置信区间，3%-7%；I² = 95%），且各地区存在显著差异。我们对单纯疱疹病毒脑炎的亚组分析结果显示，儿科患者和青少年的患病率为8%，成人的患病率为12%。单纯疱疹病毒脑膜炎的结果显示，儿科患者和青少年的患病率为4%，成人的患病率为9%。我们观察到不同地区单纯疱疹病毒1型和单纯疱疹病毒2型检测率的频率存在显著差异。对疑似病毒性中枢神经系统感染患者进行的临床旁检查不足且高度敏感，导致漏诊率高，这是可能的因素之一。需要更多研究来发现不同地区诊断过程中可能存在的缺陷。

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