{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T04:26:32Z","timestamp":1792297592820,"version":"4.4.0"},"reference-count":96,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2892,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2007,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>Hepatitis is a rare complication of herpes simplex virus (HSV), often leading to acute liver failure (ALF), liver transplantation (LT), and\/or death. Our aim was to identify variables associated with either survival or progression (death\/LT), based on an analysis of cases in the literature and our institution. A total of 137 cases (132 literature, 5 institutional) of HSV hepatitis were identified. The main features at clinical presentation were fever (98%), coagulopathy (84%), and encephalopathy (80%). Rash was seen in less than half of patients. Most cases (58%) were first diagnosed at autopsy and the diagnosis was suspected clinically prior to tissue confirmation in only 23%. Overall, 74% of cases progressed to death or LT, with 51% in acyclovir-treated patients as compared to 88% in the untreated subjects (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03). Variables on presentation associated with death or need for LT compared to spontaneous survival: male gender, age &gt;40 yr, immunocompromised state, ALT &gt;5,000 U\/L, platelet count &lt;75 \u00d7 10<jats:sup>3<\/jats:sup>\/L, coagulopathy, encephalopathy, and absence of antiviral therapy. In conclusion, HSV hepatitis has a high mortality and is often clinically unsuspected. Patients who are male, older, immunocompromised, and\/or presenting with significant liver dysfunction are more likely to progress to death and should thus be evaluated for LT early. Based on the frequent delay in HSV diagnosis, low risk-benefit ratio, and significantly improved outcomes, empiric acyclovir therapy for patients presenting with ALF of unknown etiology is recommended until HSV hepatitis is excluded. <jats:italic toggle=\"yes\">Liver Transpl 13:1428\u20131434, 2007.<\/jats:italic> \u00a9 2007 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.21250","type":"journal-article","created":{"date-parts":[[2007,9,27]],"date-time":"2007-09-27T16:47:14Z","timestamp":1190911634000},"page":"1428-1434","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":228,"title":["Herpes Simplex Virus Hepatitis"],"prefix":"10.1097","volume":"13","author":[{"given":"John P.","family":"Norvell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres T.","family":"Blei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borko D.","family":"Jovanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Levitsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-14-20250124","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1136\/jcp.22.1.60","article-title":"Acute hepatitis due to Herpes simplex virus in an adult.","volume":"22","author":"Flewett","year":"1969","journal-title":"J Clin Pathol"},{"key":"R2-14-20250124","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1093\/clinids\/9.2.329","article-title":"Herpes simplex viral hepatitis in adults: two case reports and review of the literature.","volume":"9","author":"Chase","year":"1987","journal-title":"Rev Infect Dis"},{"key":"R3-14-20250124","first-page":"448","article-title":"DT, Shakil O, McGuire B, Samuel G, Lee W, the Acute Liver Failure Study Group. 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