The Frustrations of Treating Herpes Simplex Virus Infections of the Central Nervous System

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Abstract
Significant advances have been achieved in the therapy for and diagnosis of life-threatening human herpes simplex virus (HSV) infections. Following documentation in both controlled and open studies1,2that vidarabine therapy decreased mortality and improved morbidity for patients with biopsy-proved herpes simplex encephalitis, improved outcome was achieved with acyclovir therapy.3,4The controlled studies that com See also pp 1051,1054, and 1056. pared acyclovir therapy with vidarabine therapy for herpes simplex encephalitis showed a decrease in mortality to nearly 20% six months after the onset of disease and a return to normal function in approximately 50% of survivors. Therapy for life-threatening neonatal HSV infections, namely, encephalitis and dissemination, has been more complicated. Vidarabine therapy for these forms of neonatal herpes simplex decreases mortality and improves morbidity; however, many patients are left with significant neurological impairment.5,6Babies with neonatal HSV infection are currently being followed up to assess school performance,

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