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Date Published: 13/11/2023
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DOI: https://doi.org/10.59873/vjid.v3i43.307
Issue
Vol. 3 No. 43 (2023): Tạp chí Truyền nhiễm Việt Nam
Section
Scientific research
How to Cite
Du, T. D., Nguyen, H. P., Tran, T. H. C., Nguyen, T. H. M., Diep, Y. N., Nghiem, M. N., Dong, T. H. T., Nguyen, V. V. C., & Ho, D. T. N. (2023). PROGNOSTIC FACTORS FOR ADVERSE OUTCOMES AND TREATMENT RESULTS IN HERPES SIMPLEX ENCEPHALITIS PATIENTS AT THE HOSPITAL FOR TROPICAL DISEASES IN HO CHI MINH CITY. Vietnam Journal of Infectious Diseases, 3(43), 46-54. https://doi.org/10.59873/vjid.v3i43.307

PROGNOSTIC FACTORS FOR ADVERSE OUTCOMES AND TREATMENT RESULTS IN HERPES SIMPLEX ENCEPHALITIS PATIENTS AT THE HOSPITAL FOR TROPICAL DISEASES IN HO CHI MINH CITY

Trong Duc Du, Hoan Phu Nguyen, Thi Hong Chau Tran, Thi Hoang Mai Nguyen, Yen Nhi Diep, My Ngoc Nghiem, Thi Hoai Tam Dong, Van Vinh Chau Nguyen, Dang Trung Nghia Ho

Main Article Content

Abstract

Introduction: Herpes simplex encephalitis is one of the few neuroinfectious diseases caused by a virus that has specific antiviral treatment. Accurate diagnosis requires the use of PCR-HSV in cerebrospinal fluid (CSF). Currently, there is limited information about the treatment outcomes of HSV encephalitis and factors associated with adverse outcomes in Vietnam.
Objectives: To describe the clinical manifestations, laboratory findings, treatment outcomes, and prognostic factors for adverse outcomes in patients with HSV encephalitis at the Hospital for Tropical Diseases in Ho Chi Minh City.
Methods: A retrospective descriptive study of cases was conducted.
Results: From January 2010 to December 2016, there were 75 cases of HSV encephalitis (3 cases < 15 years old) at the Hospital for Tropical Diseases in Ho Chi Minh City. All cases had positive PCRHSV in CSF. In adult patients, the most common symptoms were fever (99%), headache (87%), altered consciousness at admission (86%), and seizures (43%). Abnormalities in the brain were found in 56% (24/43) of cases on CT-scan and 91% (21/23) of cases on MRI. There were 93% (70/75) of patients received
antiviral treatment (intravenous acyclovir: 62/70, oral valacyclovir: 8/70). In cases of HSV encephalitis
treated at the Hospital for Tropical Diseases in Ho Chi Minh City, the mortality rate at discharge was 11.3%
(8/71). Multiple regression analysis (for cases treated with antiviral drugs) showed that the Glasgow Coma
Scale (GCS) at the start of the first antiviral treatment was independently associated with adverse outcomes
of patients at discharge (OR 0.60; 95% CI: 0.40 - 0.90; p = 0.013) and at 6 months after discharge (OR 0.47;
95% CI: 0.24 - 0.93; p = 0.03).
Conclusions: The GCS at the start of the first antiviral treatment is an independent prognostic factor for
the poor outcomes of HSV encephalitis patients at discharge and at 6 months after discharge.

Article Details

Keywords

Herpes simplex, encephalitis, acyclovir, valacyclovir, outcomes

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