ArticleCritical care (London, England)2020
Impact of acyclovir use on survival of patients with ventilator-associated pneumonia and high load herpes simplex virus replication.
Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Guideline
- Effect of antiviral therapy on the outcomes of mechanically ventilated patients with herpes simplex virus detected in the respiratory tract: a systematic review and meta-analysis.Critical care (London, England) · 2020Pooled it
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Histological proof of pulmonary herpesvirus presence in patients with COVID-19- or influenza-related ARDS.Critical care (London, England) · 2026Article
- Herpes Simplex Virus Infection With Multiple Cerebral Hemorrhages: A Case Report.Clinical case reports · 2026Article
- The order of infection shapes disease outcomes in influenza and herpes simplex virus coinfection by modulating immune responses.Virology journal · 2025Article
- Herpes Simplex Virus (HSV) Pneumonitis as a Late Complication of COVID-19 Infection: A Unique Case Report.Cureus · 2025Article
- Herpes Simplex Pneumonitis Presenting As Acute Respiratory Distress Syndrome and Septic Shock.Cureus · 2024Article
- ACV with/without IVM: a new talk on intestinal CDX2 and muscular CD34 and Cyclin D1 duringHelminthologia · 2024Article
- Article
- Article
- Secondary pneumonia from herpes simplex is not so simple: A case report.SAGE open medical case reports · 2024Article
- Diagnostic Dilemma of Herpes Simplex Virus Type 1 Pneumonia or Colonization: A Case Report.Infection and drug resistance · 2024Article
- The Diagnosis and Management of Herpes Simplex Pneumonia in the Critical Care Setting: A Comprehensive Review.Cureus · 2023Review
- Risk Stratification for Herpes Simplex Virus Pneumonia Using Elastic Net Penalized Cox Proportional Hazard Algorithm with Enhanced Explainability.Journal of clinical medicine · 2023Article
- Viral infections in critical care: a narrative review.Anaesthesia · 2023Review
- Treatment of a large area perioral viral herpes infection following noninvasive ventilation: A case report.World journal of clinical cases · 2023Article
- Herpes simplex virus type 1 (HSV-1) over-infection in patients with acute respiratory distress syndrome secondary to COVID-19 pneumonia: Impact on mortality.Medicina clinica (English ed.) · 2023Article
- Targeted next-generation sequencing for pulmonary infection diagnosis in patients unsuitable for bronchoalveolar lavage.Frontiers in medicine · 2023Article
- Diagnostic Value and Clinical Application of Metagenomic Next-Generation Sequencing for Infections in Critically Ill Patients.Infection and drug resistance · 2023Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHerpes simplex virus (HSV) replication can be detected in the respiratory secretions of a high proportion of ventilated intensive care unit (ICU) patients. However, the clinical significance remains poorly defined. We investigated whether patients with ventilator-associated pneumonia not responding to antibiotics and in whom high levels of HSV could be detected in respiratory secretions benefit from acyclovir treatment.
methodsRespiratory secretions (bronchoalveolar lavage fluid or tracheal aspirates) were tested for HSV replication by quantitative real-time PCR. ICU survival times, clinical parameters, and radiographic findings were retrospectively compared between untreated and acyclovir treated patients with high (> 10
resultsFifty-seven low and 69 high viral load patients were identified. Fewer patients with high viral load responded to antibiotic treatment (12% compared to 40% of low load patients, p = 0.001). Acyclovir improved median ICU survival (8 vs 22 days, p = 0.014) and was associated with a significantly reduced hazard ratio for ICU death (HR = 0.31, 95% CI 0.11-0.92, p = 0.035) in high load patients only. Moreover, circulatory and pulmonary oxygenation function of high load patients improved significantly over the course of acyclovir treatment: mean norepinephrine doses decreased from 0.05 to 0.02 μg/kg body weight/min between days 0 and 6 of treatment (p = 0.049), and median PaO
conclusionsIn patients with ventilator-associated pneumonia, antibiotic treatment failure, and high levels of HSV replication, acyclovir treatment was associated with a significantly longer time to death in the ICU and improved circulatory and pulmonary function. This suggests a causative role for HSV in this highly selected group of patients.
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