Infectious Disorders - Drug Targets

(Formerly Current Drug Targets - Infectious Disorders)

Jean-Marc Sabatier  
Laboratoire ERT 62 'Ingénierie des peptides à visée thérapeutique' 
Université de la Méditerranée
Faculté de Médecine Nord
Boulevard Pierre Dramard
13916 - MARSEILLE, Cedex 20
France

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Herpes Simplex Encephalitis: From Virus to Therapy

Author(s): Flore Rozenberg, Claire Deback and Henri Agut

Affiliation: Service de Virologie, CERVI,Groupe Hospitalier Pitie-Salpetriere, 83 bd de l'Hopital, Paris, F-75013,France.

Keywords: Encephalitis, herpes simplex virus type 1, herpes simplex virus type 2, latency, reactivation, polymerase chain reaction, antiviral drugs, resistance, HSV infection, HSE, Acyclovir, efficacy of cidofovir, immunocompromised patients, acyclovir-resistant HSV

Abstract:

Herpes simplex virus (HSV) is the cause of herpes simplex encephalitis (HSE), a devastating human disease which occurs in 2-4 cases per million/year. HSE results either from a primary infection or virus reactivation, in accordance with the common pattern of HSV infection which is a chronic lifelong process. However its pathophysiology remains largely unknown and its poor prognosis is in contrast with the usually good tolerance of most clinical herpetic manifestations. HSE is due to HSV type 1 (HSV-1) in most cases but HSV type 2 (HSV-2) may be also implicated, especially in infants in the context of neonatal herpes. Polymerase chain reaction detection of HSV DNA in cerebrospinal fluid is the diagnosis of choice for HSE. Acyclovir, a nucleoside analogue which inhibits viral DNA polymerase activity, is the reference treatment of HSE while foscarnet constitutes an alternative therapy and the efficacy of cidofovir is currently uncertain in that context. The emergence of HSV resistance to acyclovir, a phenomenon which is mainly observed among immunocompromised patients, is a current concern although no case of HSE due to an acyclovir-resistant HSV strain has been reported to date. Nevertheless the identification and development of novel therapeutic strategies against HSV appears to be a non dispensable objective for future research in virology.

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Article Details

VOLUME: 11
ISSUE: 3
Page: [235 - 250]
Pages: 16
DOI: 10.2174/187152611795768088