Long-term survival, morbidity, social functioning and risk of disability in patients with a herpes simplex virus type 1 or type 2 central nervous system infection, Denmark, 2000–2016

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Ann Brit E. Hansen, Københavns Universitet
  • ,
  • Hanne T. Vestergaard, Statens Serum Institut
  • ,
  • Ram B. Dessau, Københavns Universitet
  • ,
  • Jacob Bodilsen, Aalborg Universitet
  • ,
  • Nanna S. Andersen, Syddansk Universitet
  • ,
  • Lars H. Omland, Københavns Universitet
  • ,
  • Claus B. Christiansen, Københavns Universitet
  • ,
  • Svend Ellermann-Eriksen
  • Lene Nielsen, Københavns Universitet
  • ,
  • Thomas Benfield, Københavns Universitet
  • ,
  • Henrik T. Sørensen
  • Christian Andersen, Københavns Universitet
  • ,
  • Anne Mette Lebech, Københavns Universitet
  • ,
  • Niels Obel, Københavns Universitet

Background: The long-term prognosis following herpes simplex virus (HSV) central nervous system (CNS) infection is still debated. Patients and Methods: We examined outcomes in all Danish residents who, during 2000–2016, tested PCR positive for HSV-1 (n=208) or HSV-2 (n=283) in the cerebrospinal fluid, compared to comparison cohorts from the general population (n=2080 and n=2830). Results: One-year mortality was increased among HSV-1 patients (difference 19.3%; 95% CI: 13.6% to 25.0%) and HSV-2 patients (difference 5.3%; 95% CI: 2.5% to 8.1%), but thereafter mortality was not increased. After exclusion of persons diagnosed with cancer prior to study inclusion, one-year mortality difference for HSV-2 patients was 1.7% (−0.1% to 3.5%). After five years, HSV-1 patients had lower employment (difference −19.8%; 95% CI: −34.7% to −4.8%) and higher disability pension rates (difference 22.2%; 95% CI: 8.4% to 36.0%) than the comparison cohort, but similar number of inpatient days, outpatient visits, and sick leave. HSV-2 patients had employment and disability pension rates comparable to the comparison cohort, but more inpatient days (difference 1.5/year; 95% CI: −0.2 to 3.2), outpatient visits (difference 1.3/year; 95% CI: 0.3 to 3.2), and sick leave days (difference 9.1/ year; 95% CI: 7.9 to 10.4). Conclusion: HSV-1 and HSV-2 CNS infections differ substantially with respect to prog-nosis. HSV-1 CNS infection is followed by increased short-term mortality and long-term risk of disability. HSV-2 CNS infection has no substantial impact on mortality or working capability but is associated with increased morbidity.

OriginalsprogEngelsk
TidsskriftClinical epidemiology
Vol/bind12
Sider (fra-til)745-755
Antal sider11
ISSN1179-1349
DOI
StatusUdgivet - jul. 2020

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