Acyclovir Treatment for Ventilated ICU Patients With Pneumonia and Herpes Simplex Virus in Lung Fluid

What this Trial Is About

Herpes simplex viruses HSV are carried by almost 90% of people and remain in the body for life, usually dormant. Reactivation occurs mainly when the immune system is weakened, causing mostly harmless cold sores but potentially serious infections like meningitis in immunocompromised individuals. This study is investigating whether treating HSV with acyclovir can improve survival in ventilated intensive care patients with pneumonia who have a high amount of HSV detected in their respiratory tract, as current evidence from retrospective studies is inconclusive. The trial compares two groups of ICU patients on mechanical ventilation with lower respiratory tract infection and HSV-1 detected in bronchoalveolar lavage BAL. One group receives intravenous acyclovir at 10 mgkg every 8 hours for up to 10 days or until ICU discharge, while the control group receives no antiviral therapy. The study is randomized and controlled to provide clear evidence on the effects of antiviral treatment in this patient population. Participants will be monitored for survival status at 30 days as the primary outcome. Secondary outcomes include ventilation-free days, vasopressor-free days, organ failure assessment scores, kidney function, length of ICU and hospital stay, quality of life measures, microbiological cure, and safety events. The study involves multiple assessments up to 180 days and tracks cost and adverse events, aiming to clarify the role of acyclovir therapy in improving outcomes for ventilated ICU patients with HSV-related pneumonia.

Acyclovir in Ventilated Patients With Pneumonia and HSV-1 in BAL