Viral Antidote

New drug checks herpes simplex encephalitis

Exceedingly few people develop herpes simplex encephalitis, a brain inflammation produced by the same virus that causes, among other things, the common cold sore. Those who do are unfortunate indeed. Fever, recurrent headaches, personality changes and seizures often afflict the victim, though the disease can be definitely confirmed only by brain biopsy. Once it starts, moreover, it steadily gets worse. People with herpes encephalitis almost invariably become comatose, then die; survivors nearly always suffer brain damage, frequently so severe as to require institutionalization.

In the past there has been no safe and effective treatment, but now a remedy seems at hand. A research team headed by Dr. Charles Alford of the University of Alabama in Birmingham reported last week it has successfully tested a drug that will not only prevent death in most cases of herpes encephalitis but also radically reduce the incidence of neurological damage in survivors. "Even with its limitations," said Alford, "this represents a major breakthrough in antiviral therapy."

The team, comprising doctors from 15 universities, published its study in the New England Journal of Medicine and simultaneously announced it at a press conference at the National Institute of Allergy and Infectious Diseases in Bethesda, Md. The findings are based on work with a drug called adenine arabinoside, a compound originally discovered in sponges, and on treatment of 50 patients with symptoms of herpes encephalitis.

The results of the team's study are impressive. Of the ten" confirmed encephalitis victims who received a placebo, seven died of the disease.* Of the 18 confirmed cases treated with adenine arabinoside, only 5, or 28%, succumbed. Of the survivors, a significant number recovered completely. The researchers reported that half suffered only moderate neurological damage or none at all.

Herpes viruses are among the most common and tenacious of the pathogens, or disease-causing agents, that plague man. Though adenine arabinoside, which had earlier been tested unsuccessfully as an anticancer drug, has been used experimentally--and with encouraging results--on a variety of herpes infections since 1970, Dr. Alford and his associates are still not sure exactly how it works. They admit that further research must also be done on dosage limits, mode of administration and possible side effects before the drug, which until now has been used only for investigational purposes, becomes available more generally. But they are confident that adenine arabinoside, which has also shown some encouraging effects against such other members of the herpes family as the viruses that cause chicken pox and the painful nerve inflammation called shingles, is here to stay.

After compiling the results of the study, the research team has decided against conducting any further studies in which the victims of herpes encephalitis are given placebos. Adenine arabinoside has proved so effective against this particular deadly disease, they agree that it would be unethical not to administer it. -

*The deaths of these patients were in no way due to denial of proper care; until the new drug's effectiveness was proved, doctors had no reason to believe that adenine arabinoside would be any better than no treatment at all.

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