Are Glucocorticoids Truly Effective in Improving the Clinical Prognosis of HSV-1 Encephalitis?

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES Infection and Drug Resistance Pub Date : 2025-03-05 eCollection Date: 2025-01-01 DOI:10.2147/IDR.S501628

Shuhua Xie, Wei Sun, Zhaohui Lai, Xianghong Liu

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Abstract

Background: Survivors of herpes simplex encephalitis (HSE) commonly experience significant neurological sequelae, imposing a substantial burden on both society and families. The efficacy of glucocorticoids in treating patients with HSE remains controversial. This study aims to evaluate the effectiveness of glucocorticoids in patients with HSE and analyze the clinical characteristics of this patient population.

Methods: This retrospective study evaluated the clinical characteristics, auxiliary examinations, and patient prognosis of HSE patients diagnosed with mNGS, and analyzed the prognosis of patients in both Glucocorticoid and Non-glucocorticoid groups. Assess the prognosis based on the improvement of GOS score and MMSE score at 1 and 3 months after discharge.

Results: A retrospective analysis was conducted in 29 hSE patients who met the criteria for GOS score improvement 3 months after discharge. The hormone group was better than the non-hormone group (2 (0-2) scores VS 1 (1-2) scores). There was no significant difference between the two groups in GOS score 1 month after discharge. However, no statistical difference was found in improving patient outcomes between the two groups.

Conclusion: Despite the hormone group not obtaining the anticipated positive outcomes, potentially due to the relatively limited sample size in this study, previous case series reports have indicated that glucocorticoids, when used as an adjunct to acyclovir therapy, may enhance patient outcomes. Consequently, further extensive clinical studies involving multiple centers and larger sample sizes are warranted to investigate this matter further.

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糖皮质激素真的能有效改善1型单纯疱疹病毒脑炎的临床预后吗？

背景：单纯疱疹脑炎（HSE）的幸存者通常会经历严重的神经系统后遗症，给社会和家庭带来沉重的负担。糖皮质激素治疗HSE患者的疗效仍存在争议。本研究旨在评价糖皮质激素治疗HSE患者的有效性，并分析该患者人群的临床特点。方法：回顾性分析诊断为mNGS的HSE患者的临床特点、辅助检查及患者预后，并分析糖皮质激素组和非糖皮质激素组患者的预后。根据出院后1、3个月GOS评分和MMSE评分的改善情况评估预后。结果：回顾性分析29例出院后3个月GOS评分改善符合标准的hSE患者。激素组优于非激素组（2（0-2）分VS 1（1-2）分）。两组患者出院后1个月GOS评分差异无统计学意义。然而，两组在改善患者预后方面没有统计学差异。结论：尽管激素组没有获得预期的积极结果，可能是由于本研究的样本量相对有限，但先前的病例系列报告表明，糖皮质激素作为阿昔洛韦治疗的辅助治疗可能会提高患者的预后。因此，进一步广泛的临床研究涉及多个中心和更大的样本量是必要的，以进一步调查这个问题。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.