| ORIGINAL ARTICLE |
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| Year : 2021 | Volume
: 2
| Issue : 3 | Page : 74-78 |
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Antiviral therapy for herpes simplex virus encephalitis: Systematic review and meta-analysis of randomized control trials
Sridhar Amalakanti1, Sri Harsha Boppana1, Nagarjuna Sivaraj2, Kesava Venkata Raman Arepalli1, Tarun Kumar Suvvari3
1 Department of General Medicine, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India
2 Central Research Lab, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India
3 Dr. NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India
Correspondence Address:
Dr. Sridhar Amalakanti
Department of General Medicine, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jascp.jascp_13_21
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Background: Herpes simplex virus (HSV) infection of the brain is treated with antiviral drugs such as acyclovir. A summary of randomized control trials (RCTs) of antiviral drugs against HSV encephalitis has not been put forward yet. We aimed to determine the effect of antiviral agents in treating HSV encephalitis on mortality and neurological sequelae at approximately 2 years. The secondary objective was to assess the adverse effect of antiviral agents on the patients. Materials and Methods: RCTs were identified by searching PUBMED, European Medicines Agency ( EMA ), USFDA, US Clinical trials, Elsevier database, and Cochrane website and the reference lists of published trials. Randomized controlled trials of antiviral therapy in biologically proven HSV infection were included in the study. Results: A total of 5 studies met the criteria. The first study was published in 1980 and the latest was in 2015. All the studies used acyclovir/valacyclovir or vidarabine. Three studies compared acyclovir and vidarabine, one study was placebo-controlled vidarabine trial and another one was a placebo-controlled trial of long-term valacyclovir therapy. Acyclovir improved mortality and lowered the incidence of neurological sequelae. There was no significant reduction in the risk of mortality with vidarabine therapy. Conclusion: Trial evidence suggests that acyclovir decreases mortality and morbidity in acute HSV encephalitis.
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