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Invited Commentary
December 16, 2019

Preemptive Treatment of Herpes Simplex Virus Reactivation in Critically Ill Patients?—Not Based on Current Data

Author Affiliations
  • 1Department of Medical Microbiology and Infection Control, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
  • 2Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands
  • 3Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, the Netherlands
  • 4Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, the Netherlands
JAMA Intern Med. 2020;180(2):272-273. doi:10.1001/jamainternmed.2019.6423

In a multicenter randomized clinical trial by Luyt et al1 published in this issue of JAMA Internal Medicine, twice-weekly screening for oropharyngeal reactivation of herpes simplex virus (HSV) followed by preemptive treatment with acyclovir during 14 days did not increase the number of ventilator-free days at day 60 in patients who received mechanical ventilation in the intensive care unit (ICU). The study informs a debate that has been ongoing for decades regarding the clinical relevance of HSV reactivation in patients without an apparent prior immunocompromised condition.

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