<p>Long-Term Survival, Morbidity, Social Functioning and Risk of Disability in Patients with a Herpes Simplex Virus Type 1 or Type 2 Central Nervous System Infection, Denmark, 2000–2016</p>

Abstract

Background: The long-term prognosis following herpes simplex virus (HSV) central nervous system (CNS) infection is still debated. Patients and Methods: We examined outcomes in all Danish residents who, during 2000-2016, tested PCR positive for HSV-1 (n=208) or HSV-2 (n=283) in the cerebrospinal fluid, compared to comparison cohorts from the general population (n=2080 and n=2830). Results: One-year mortality was increased among HSV-1 patients (difference 19.3%; 95% CI: 13.6% to 25.0%) and HSV-2 patients (difference 5.3%; 95% CI: 2.5% to 8.1%), but thereafter mortality was not increased. After exclusion of persons diagnosed with cancer prior to study inclusion, one-year mortality difference for HSV-2 patients was 1.7% (−0.1% to 3.5%). After five years, HSV-1 patients had lower employment (difference −19.8%; 95% CI: −34.7% to −4.8%) and higher disability pension rates (difference 22.2%; 95% CI: 8.4% to 36.0%) than the comparison cohort, but similar number of inpatient days, outpatient visits, and sick leave. HSV-2 patients had employment and disability pension rates comparable to the comparison cohort, but more inpatient days (difference 1.5/year; 95% CI: −0.2 to 3.2), outpatient visits (difference 1.3/year; 95% CI: 0.3 to 3.2), and sick leave days (difference 9.1/ year; 95% CI: 7.9 to 10.4). Conclusion: HSV-1 and HSV-2 CNS infections differ substantially with respect to prognosis. HSV-1 CNS infection is followed by increased short-term mortality and long-term risk of disability. HSV-2 CNS infection has no substantial impact on mortality or working capability but is associated with increased morbidity.

Epidemiology and long‐term neurological sequelae of childhood herpes simplex CNS infection

“…Clinical outcomes in HSV CNS infection are difficult to predict with recognised high rates of neurological morbidity, even with early diagnosis and prompt treatment 6,22–24 . A higher proportion of non‐neonates with HSV 1 had adverse neurological sequelae compared to HSV 2.…”

Disrupting Neurons and Glial Cells Oneness in the Brain—The Possible Causal Role of Herpes Simplex Virus Type 1 (HSV-1) in Alzheimer’s Disease

“…Although they are known to exist, the prevalence of such infections is not underpinned in the population level. Research regarding the long-term consequences of HSV-1 infections of the CNS are scarce, and often hampered by small/selected study groups limited to patients with severe HSV encephalitis [ 99 ].…”

Recurrence risk after a first remote symptomatic seizure in adults: Epilepsy or not?

“…[59][60][61] Recent large studies describing seizures after brain infections combine acute symptomatic and unprovoked seizures and do not report recurrence risks after one remote seizure. [62][63][64][65][66] Prospective studies are needed for better information on recurrence risks. Advances in big data can perhaps facilitate generation of such knowledge.…”

“… 59 , 60 , 61 Recent large studies describing seizures after brain infections combine acute symptomatic and unprovoked seizures and do not report recurrence risks after one remote seizure. 62 , 63 , 64 , 65 , 66 …”