ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Herpes Simplex Virus Type 1 Encephalitis: A Prospective Population-Based Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Herpes simplex virus pUL56 abolishes neuronal activity by removing voltage-gated ion channels from the plasma membrane.Science advances · 2026Article
- A Fatal Herpes Simplex Encephalitis with a Normocellular Cerebrospinal Fluid: A Case Report.Journal of clinical medicine · 2026Article
- Herpes simplex virus encephalitis following acute brain injury: illustrative cases.Journal of neurosurgery. Case lessons · 2026Article
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Authors and funding
14 authors.
Funding
Abstract
backgroundThis study was performed to investigate the clinical characteristics and outcome of patients with herpes simplex (HSV) type 1 encephalitis.
methodsNationwide, prospective, population-based cohort study using the Danish Study Group for Infections of the Brain database to identify all adults hospitalized with microbiologically confirmed HSV-1 encephalitis from 2015 to 2023 in Denmark. Modified Poisson regression was used to estimate the relative risk (RR) with 95% confidence intervals (CI) for 6-month mortality, adjusted for age, sex, immunocompromise, altered mental status, imaging abnormalities, time to acyclovir (>6 hours from admission), and pathogen. Analysis of acyclovir delay >6 hours was repeated post-hoc using time after lumbar puncture as reference.
resultsA total of 154 patients with confirmed HSV-1 encephalitis were included, yielding a mean annual incidence of 0.36/100.000. Frequent symptoms at admission included a history of fever (in 101/128 [79%]) and confusion (in 99/154 [78%]). The median times from admission to lumbar puncture and acyclovir treatment were 21 (interquartile range, 6-70) and 24 (7-74) hours, respectively. The adjusted RR for 6-month mortality was 1.15 (95% CI, 0.39-3.41) for acyclovir initiation >6 hours after admission and 1.06 (95% CI, 1.004-1.13) for each day of delay after admission. The adjusted RR of 6-month mortality was 1.85 (95% CI, 1.01-3.45) for delayed acyclovir treatment of >6 hours since lumbar puncture. Anti N-Methyl-D-aspartate receptor encephalitis was diagnosed in 9/154 (6%) of patients after HSV-1 encephalitis.
conclusionsEarly recognition of HSV-1 encephalitis remains challenging, and the condition is associated with high mortality. Delayed acyclovir treatment, especially following lumbar puncture, was associated with increased risks of fatal outcome.
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