单纯疱疹病毒口咽再激活机械通气患者预防性阿昔洛韦预防单纯疱疹病毒支气管肺炎:一项针对单纯疱疹病毒试验的预防性治疗的辅助研究

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES Antiviral Therapy Pub Date : 2022-02-01 DOI:10.1177/13596535211072673
Antoine Troger, S. Burrel, M. Pineton de Chambrun, M. Schmidt, N. Brechot, Olivier Bomme, G. Hékimian, A. Combes, D. Boutolleau, C. Luyt
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引用次数: 0

摘要

背景:在单纯疱疹病毒口咽再激活的机械通气患者中,评估先发制人的阿昔洛韦治疗对单纯疱疹病毒(HSV)支气管肺炎的影响。方法辅助研究疱疹病毒科(PTH)预防性治疗的临床试验。本研究纳入了来自一个中心(Pitié-Salpêtrière医院)的试验患者,这些患者至少接受了一次支气管肺泡灌洗(BAL)治疗,怀疑是呼吸机相关性肺炎。在接受阿昔洛韦或安慰剂治疗的患者中,比较HSV支气管肺炎的发生率,即表明肺炎的临床症状和BAL液中存在HSV≥105拷贝HSV/106细胞。结果83例患者入选;40人接受了先发制人的阿昔洛韦治疗,43人接受了安慰剂治疗,在入院或随机分组时各组之间没有差异。在阿昔洛韦治疗的患者中,发生HSV支气管肺炎的患者数量低于安慰剂治疗的患者(分别为40%和72%,p=0.003)。当随机分组时仅限于下呼吸道未检测到HSV的患者时,结果相似(分别为31%和61%,p=0.03)HSV口咽再激活的通气患者可降低HSV支气管肺炎的发生率。
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Preemptive acyclovir to prevent herpes simplex virus bronchopneumonitis in mechanically ventilated patients with herpes simplex virus oropharyngeal reactivation: An ancillary study of the preemptive treatment for herpesviridae trial
Background To evaluate the impact of preemptive acyclovir treatment on herpes simplex virus (HSV) bronchopneumonitis in mechanically ventilated patients with HSV oropharyngeal reactivation. Methods Ancillary study of the Preemptive Treatment for Herpesviridae (PTH) clinical trial. Patients included in that trial from one centre (Pitié-Salpêtrière Hospital) and in whom at least one bronchoalveolar lavage (BAL) was performed for ventilator-associated pneumonia suspicion were included in the present study. Rate of HSV bronchopneumonitis, defined as clinical symptoms suggesting of pneumonia and presence of HSV in BAL fluid ≥105 copies of HSV/106 cells, were compared in patients who received either acyclovir or placebo. Results Eighty-three patients were included; 40 having received preemptive acyclovir and 43 having received a placebo, without differences between groups at admission or at randomization. The number of patients who developed HSV bronchopneumonitis was lower among acyclovir-treated patients than among placebo-treated patients (40% vs. 72%, respectively, p = .003). Results were similar when restricted to patients without HSV detected in the lower respiratory tract at randomization (31% vs. 61%, respectively, p = .03). Conclusions Preemptive acyclovir treatment in mechanically ventilated patients with HSV oropharyngeal reactivation reduces HSV bronchopneumonitis rate.
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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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