Öz
Herpes simpleks virüsü (HSV) erişkinlerde sporadik enfektif ensefalitin en sık nedenidir. Antiviral tedavilere rağmen, olgu fatalite oranı orta ila yüksek arasında değişen oranlarda (çalışma ve ülkelere göre %5 ila %30) değişmektedir. Tanı yöntemlerinin bir tarafında beyin omurilik sıvısında spesifik polimeraz zincir reaksiyonu testleri diğer tarafında manyetik rezonans görüntüleme yer almaktadır. Çeşitli ülkelerin tedavi rehberleri, günde üç kez sistemik 10 mg/kg asiklovir tedavisinin mikrobiyolojik doğrulama beklenmeden başlanmasını önermektedir. Diğer bir soru kortikosteroidlerin yararlı olup olmadığıdır. Bu soru geç dönem sekel sıklığı (hastaların %30-40"ı) ve yakın zamanda bildirilen HSV ile tetiklenen otoimmün ensefalit ile ilgilidir. Bu iki olası komplikasyonda, profilaktik tedavi olarak steroidler yararlı olabilir, ancak kesinlik kazanması için yapılacak spesifik klinik çalışmalara ihtiyaç vardır. Genetik özellikler yakın zamanda tanımlanmış ve bazı hastalardaki ensefalit oluşumunu açıklamıştır, ancak henüz tüm olguları açıklayamamaktadır.
Anahtar Kelimeler: Asiklovir, herpes simpleks virüs, sekel, otoimmün ensefalit, gansiklovir
Kaynakça
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Dex Enceph clinical trial registration. ClinicalTrials.gov PRS: 38RC16.015 (French study), and EudraCT: 2015-001609-16 (UK study).
