Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. National Institute of Allergy and Infectious Diseases collaborative antiviral study

N Engl J Med. 1977 Aug 11;297(6):289-94. doi: 10.1056/NEJM197708112970601.


We evaluated adenine arabinoside (vidarabine) for treatment of herpes simplex encephalitis in a placebo-controlled study. In 28 cases proved by isolation of Type 1 virus from brain biopsy, treatment reduced mortality from 70 to 28 per cent (P = 0.03), and over 50 per cent of treated survivors had no or only moderately debilitating neurologic sequelae. This improvement was achieved without evidence of acute drug toxicity. Thus, adenine arabinoside has a good therapeutic index (efficacy/toxicity) for the treatment of Type 1 herpes simplex encephalitis. However, the drug must be given early in the course of infection before the advent of coma to have a beneficial effect. Moreover, it should be coupled with brain biopsy for specific diagnosis to avoid unnecessary treatment of nonresponsive encephalitides that can mimic herpes simplex.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Biopsy
  • Brain / microbiology
  • Clinical Trials as Topic
  • Drug Evaluation
  • Encephalitis / diagnosis
  • Encephalitis / drug therapy*
  • Encephalitis / etiology
  • Female
  • Follow-Up Studies
  • Herpes Simplex / drug therapy*
  • Herpes Simplex / mortality
  • Humans
  • Male
  • Simplexvirus / isolation & purification
  • Vidarabine / administration & dosage
  • Vidarabine / adverse effects
  • Vidarabine / therapeutic use*


  • Vidarabine