Publication
Title
Is acyclovir effective among critically ill patients with herpes simplex in the respiratory tract?
Author
Abstract
Background and objective: The relevance of the detection of herpes simplex virus type 1 (HSV-1) in the respiratory tract of patients in the intensive care unit (ICU) is unclear. Therefore, it is uncertain whether treatment with an antiviral agent could be beneficial for these patients. Study design: We retrospectively reviewed the records of ICU patients with a positive HSV-1 culture in the respiratory tract or bronchoalveolar lavage (BAL) fluid. We evaluated whether acyclovir treatment (n=106) could have a beneficial effect on mortality as compared with the standard treatment (n=106). Results: Acyclovir treatment was positively linked to in-hospital and ICU-mortality reduction. This favourable influence remained present after correcting for possible confounders and using propensityadjusted and propensity-matched cohorts: with an odds ratio in the treated group of 3.19 (95% CI 1.79-5.69, p = 0.001) for ICU survival and of 3.55 (95% CI 2.16-5.85, p< 0.001) for in-hospital survival. The subgroup with HSV-1 detected in the BAL-fluid is the sole contributor to this difference. In the BAL-fluid detected group, 48% (n=10) of non-treated patients died in the ICU, versus 21% (n= 6) in the acyclovir-treated group (p =0.033), occurring despite an even longer duration of ventilation or ICU stay. Conclusions: These data highlight the hypothesis that it might be worthwhile to consider treatment of HSV-1 in ICU patients depending on the type of respiratory sample in which the virus is detected. These results warrant a prospective trial to prove causality. (C) 2014 Elsevier B.V. All rights reserved.
Language
English
Source (journal)
Journal of clinical virology. - Rome
Publication
Rome : 2014
ISSN
1386-6532
Volume/pages
60:3(2014), p. 215-221
ISI
000339287200006
Full text (Publishers DOI)
Full text (publishers version - intranet only)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 08.09.2014
Last edited 29.04.2017
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