Journal of NeuroVirology

, Volume 9, Issue 1, pp 118–125

Experimental herpes simplex virus encephalitis: A combination therapy of acyclovir and glucocorticoids reduces long-term magnetic resonance imaging abnormalities

  • Uta K. Meyding-Lamadé
  • Christoph Oberlinner
  • Philipp R. Rau
  • Sonja Seyfer
  • Sabine Heiland
  • Johann Sellner
  • Brigitte T. Wildemann
  • Wolfram R. Lamadé
Short Communication

Abstract

Despite early antiviral treatment, herpes simples virus encephalitis (HSVE) still remains a life-threatening sporadic disease with high mortality and morbidity. In patients and in experimental disease, chronic progressive magnetic resonance imaging (MRI) abnormalities have been found even after antiviral therapy. Secondary autoimmune-mediated and not directly virus-mediated mechanisms might play a key role for the outcome of disease. This study aimed to evaluate a possible beneficial effect of a therapy of acyclovir and corticosteroids versus acyclovir only. In a mouse model of HSVE (intranasal inoculation with 105 pfu [plaque-forming units] of HSV-1 strain F), a long-term MRI study was realized. Cranial MRI was performed serially at days 2, 7, 14, 21, 60, and 180 in different therapy groups: 1, saline; 2, acyclovir; 3, acyclovir, subsequently methylprednisolone; 4, sham-infected with saline. Brain viral load peaked at day 7 to decline thereafter to a low baseline value. Viral load in group 1 was significantly higher than in animals with antiviral therapy. In group 4, no viral DNA was detectable. Viral load did not differ significantly between acyclovir and acyclovir/corticosteroid-treated groups, suggesting that the use of corticosteroids in addition to acyclovir does not increase viral burden. MRI findings in untreated and acyclovir-treated animals revealed chronic progressive changes. In contrast, there was a significant reduction of the severity of long-term MRI abnormalities in acyclovir/corticosteroid-treated animals. With respect to abnormal MRI findings, this study demonstrates a clear beneficial effect of an acyclovir and corticosteroid therapy without influencing brain viral load.

Keywords

acyclovir corticosteroids experimental herpes simplex encephalitis HSV-1 infection magnetic resonance imaging 

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Copyright information

© Journal of NeuroVirology, Inc. 2003

Authors and Affiliations

  • Uta K. Meyding-Lamadé
    • 1
  • Christoph Oberlinner
    • 1
  • Philipp R. Rau
    • 1
  • Sonja Seyfer
    • 1
  • Sabine Heiland
    • 2
  • Johann Sellner
    • 1
  • Brigitte T. Wildemann
    • 1
  • Wolfram R. Lamadé
    • 3
  1. 1.Department of NeurologyINF 400 KopfklinikHeidelbergGermany
  2. 2.Division of NeuroradiologyINF 400 KopfklinikHeidelbergGermany
  3. 3.Department of SurgeryINF 110HeidelbergGermany

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