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Herpes simplex virus encephalitis diagnosis and treatment of


Virus or cell, nuclear inclusion bodies. The current means of laboratory tests have been developed to HSV monoclonal antibodies and DNA hybridization, except for clinical diagnosis, but also for HSV Isolation and identification of subtypes. Differential diagnosis by means of clinical observation and laboratory methods should be considered pathogenic factors and other biological immunogenicity caused by viral, bacterial and fungal encephalitis and meningoencephalitis, in addition to attention to intracranial mass lesions ( brain abscess, tumor) of the identification. 5 Treatment and prevention of the first generation of antiviral drugs, such as herpes net and Ara-C, because of their toxicity and metabolism in the body quickly and the loss of therapeutic effect to be eliminated. The second generation of antiviral drugs, such as Vidarabine,[link widoczny dla zalogowanych], acyclovir (aciclovir) and ganciclovir (dihydrox3, propoxymethy1guanine, DHPG) has been used clinically. Vidarabine a broad-spectrum antiviral activity, the molecular basis of this role is its ability to inhibit the viral DNA and mixed and competitive inhibition of virus-encoded DNA polymerase. In addition, through inhibition of Ribonucleotide reductase and prevent the degradation of adenosine inhibition of homocysteine ​​methyl donor, preventing methylation of mRNA and tRNA. Acyclovir and ganciclovir are derivatives of guanine, which inhibit viral DNA replication leading to viral structural proteins (7 like peptide) sets into play the obstruction of anti-viral activity. The mechanism is when the HSV infection, the virus first generated a class of peptides, polypeptides and then guide the delivery time by the class of virus mouth like peptide synthesis, guided by the mouth like peptide 7, like peptide synthesis. , B class of peptides are virus non-structural proteins, peptides, compared with 7 categories virus structural proteins. Viral DNA replication depend on the virus-encoded DNA polymerase, and ganciclovir and acyclovir DNA polymerase inhibitors can be used as a precursor, to play the role of inhibition of DNA polymerase, resulting in viral DNA synthesis blocked,[link widoczny dla zalogowanych], thereby inhibiting viral RNA until the virus protein synthesis. In addition, acyclovir and ganciclovir in HSV infected cells by adenosine kinase (TK) activation and phosphorylation, acyclovir triphosphate, or targets of ganciclovir in virus DNA polymerase, and thus DNA polymerase is inhibited, leading to viral DNA synthesis blocked. Applied dose acyclovir, newborn (more than 6 months old) HSE at a dose of SO0ms/m2, intravenous injection Li River, every 8 hours daily for ten days. Adult HSE is 3o. ~ / (Kg · d),[link widoczny dla zalogowanych], intravenous infusion three times, l4-2l-day course of treatment, relapse is often less than l0 days. Has proved to be acyclovir resistant strains have been increasing, especially HIV. 1 infected patients. Clinically, almost all of the combat performance of acyclovir in the treatment already received multiple intermittent damage to the immune function of patients seen. In patients who have received drug treatment, when the lesions have high titers of virus or virus reactivation occurs frequently, often can detect variant virus. Most of acyclovir resistant HSV strains have changed the role of its phosphorylation substrate specificity. This acyclovir triphosphate intracellular level is reduced. In some patients, large doses of acyclovir to clear the lesions. However, in other patients, even with large doses does not prevent disease progression. If the dose is large enough, the plasma concentrations high enough to still persistent lesions from isolated HSV, should be suspected acyclovir resistant viral strains. Lin sodium (Foscamet) is also effective antiviral drugs. The brand name made available foscarnet-resistant, resistant strains of clinical effect. IFN, interferon inducer (poly), transfer factor, immune globulin is also applied, but the effects are uncertain. Symptomatic treatment as the condition of patients and the post. As HSE serious condition with high mortality, and sexually transmitted diseases,[link widoczny dla zalogowanych], genital herpes and neonatal herpes disease increased,[link widoczny dla zalogowanych], thereby promoting the development of HSV vaccines work. However, the exact role of prevention of HSV infection needs further observational study. 6
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