Evidence map›Paper›PMID 42911476›Full record

Observational studyJournal of neurovirology2026

Development of a risk score to predict encephalitis by Herpes Simplex Virus and Varicella Zoster Virus.

Jose Portugal Gonzales, Ashley N Heck, Paris Bean, Ralph Habis, John C Probasco, Arun Venkatesan, Rodrigo Hasbun

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of neurovirology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jose Portugal GonzalesDepartment of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center at Houston, 6410 Fannin St., Houston, TX, 77030, USA. jose.f.portugalgonzales@uth.tmc.edu.ORCID http://orcid.org/0009-0009-0688-1033
Ashley N HeckDepartment of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center at Houston, 6410 Fannin St., Houston, TX, 77030, USA.
Paris BeanDepartment of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center at Houston, 6410 Fannin St., Houston, TX, 77030, USA.
Ralph HabisDepartment of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins School of Medicine, 1800 Orleans St., Baltimore, MD, 21287, USA.
John C ProbascoDepartment of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins School of Medicine, 1800 Orleans St., Baltimore, MD, 21287, USA.
Arun VenkatesanDepartment of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins School of Medicine, 1800 Orleans St., Baltimore, MD, 21287, USA.
Rodrigo HasbunDepartment of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center at Houston, 6410 Fannin St., Houston, TX, 77030, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Encephalitis guidelines recommend repeating a lumbar puncture (LP) 3-7 days after an initial negative cerebrospinal fluid (CSF) herpes simplex virus (HSV) polymerase chain reaction (PCR) test in patients with high suspicion for HSV or varicella zoster virus (VZV), but this subgroup has not been specified. Retrospective observational study of 602 adults with encephalitis from 2002 to 2023 from two large U.S. healthcare systems. Multivariate logistic regression models were developed and internally validated to identify clinically relevant and statistically significant features predicting HSV, VZV, and combined HSV/VZV encephalitis. HSV and VZV encephalitis were diagnosed in 103 (17.1%) and 43 (7.14%), respectively. Independent predictors for HSV acute presentation, new temporal lobe abnormalities on MRI, and hemorrhage on brain MRI. For VZV, predictors were immunosuppression, Charles Comorbidity Index > 2, and absence of seizures on presentation. For HSV/VZV, predictors included age ≥ 50 years, immunocompromise, acute presentation, CSF lymphocytosis, new temporal lobe abnormalities on MRI, hemorrhage on brain MRI, and Glasgow Coma Scale (GCS) ≥ 13 (P < 0.05). Patients were classified into 3 categories: low-risk (0 points), intermediate-risk (1 point), and high-risk (≥ 2 points). The area under the receiver operating curve was 0.675, 0.734, and 0.583 for the HSV, VZV, and HSV/VZV models, respectively. The risk score can help identify patients with an initial negative PCR who would benefit from a repeat LP (intermediate- or high-risk) and may support discontinuing acyclovir in low-risk patients.

Indexed as

Encephalitis, Herpes SimplexEncephalitis, Varicella ZosterAdultAgedFemaleHerpesvirus 3, HumanHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesRisk FactorsSimplexvirusAdultsEncephalitisHerpes Simplex VirusPrediction modelRisk scoreVaricella Zoster Virus

Identifiers

PMID42911476

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.