Aciclovir Versus Placebo for HSV-2 Meningitis

Exclusion Criteria

• •Patients fulfilling any of the following criteria will be excluded:
• •1. Encephalitis as defined by the International Encephalitis Consortium if diagnosed during standard care (see Glossary)20
• •2. Transverse myelitis as defined by the Transverse Myelitis Consortium Working Group if diagnosed during standard care (see Glossary)21
• •3. Severe immuno-compromise defined as an ongoing need for biological- or chemotherapy (e.g. natalizumab), prednisolone \>20 mg/day for ≥14 days, uncontrolled HIV/AIDS (see glossary), haematological malignancies, and organ transplant recipients14,18,22
• •4. Moderate to severe concomitant genital herpes requiring systemic aciclovir
• •5. Pregnancy (proven by positive urine or plasma human chorionic gonadotropin test in fertile women)
• •6. Hepatic impairment (aspartate aminotransferase or alanine aminotransferase levels \>5 times the upper limit of normal)
• •7. Impaired renal function (estimated glomerular filtration rate \<25 mL/min)
• •8. Intolerance to (val)aciclovir
• •9. Probenecid treatment
• •10. Systemic antiviral therapy with an antiherpetic effect for \>24 hours
• •11. Previous enrolment into this trial