背景:马疱疹病毒1型(EHV-1)感染与上呼吸道疾病有关,神经系统疾病,堕胎,新生儿死亡。
目的:药物治疗是否可以降低驯养马中EHV-1引起的疾病或感染的发生率或严重程度?
方法:进行了系统综述,CAB文摘,科克伦,PubMed,WebofScience,和世卫组织全球健康指数医学区域数据库,以确定2021年2月15日之前发表的文章。选择标准是发表在同行评审期刊上的原始研究报告,以及研究在体内使用治疗剂预防或治疗马中的EHV-1的研究。评估的结果包括与反映有症状的EHV-1感染或病毒感染的临床结果相关的指标。我们评估了偏倚风险,并对干预措施的证据质量进行了分级评估。
结果:共确定了7009项独特研究,其中9人符合纳入标准。两项研究评估了伐昔洛韦或小干扰RNA,单个研究评估了基于副痘病毒的免疫调节剂的使用,人α干扰素,草药补充剂,胞嘧啶类似物,还有肝素.证据水平介于随机对照研究和观察性试验之间。偏倚的风险是中等到高,样本量很小。大多数研究报告所测试的干预措施没有益处或效果最小。
结论:我们的综述表明,在缓解EHV-1相关疾病转归的任何研究干预措施中,作为预防性或暴露后治疗的益处最小或有限。
BACKGROUND: Equine herpes virus type 1 (EHV-1) infection in horses is associated with upper respiratory disease, neurological disease, abortions, and neonatal death.
OBJECTIVE: Does pharmacological therapy decrease either the incidence or severity of disease or infection caused by EHV-1 in domesticated horses?
METHODS: A systematic
review was preformed searching AGRICOLA, CAB Abstracts, Cochrane, PubMed, Web of Science, and WHO Global Health Index Medicus Regional Databases to identify articles published before February 15, 2021. Selection criteria were original research reports published in peer reviewed journals, and studies investigating in vivo use of therapeutic agents for prevention or treatment of EHV-1 in horses. Outcomes assessed included measures related to clinical outcomes that reflect symptomatic EHV-1 infection or virus infection. We evaluated risk of bias and performed a GRADE evaluation of the quality of evidence for interventions.
RESULTS: A total of 7009 unique studies were identified, of which 9 met the inclusion criteria. Two studies evaluated valacyclovir or small interfering RNAs, and single studies evaluated the use of a Parapoxvirus ovis-based immunomodulator, human alpha interferon, an herbal supplement, a cytosine analog, and heparin. The level of evidence ranged between randomized controlled studies and observational trials. The risk of bias was moderate to high and sample sizes were small. Most studies reported either no benefit or minimal efficacy of the intervention tested.
CONCLUSIONS: Our
review indicates minimal or limited benefit either as a prophylactic or post-exposure treatment for any of the studied interventions in the mitigation of EHV-1-associated disease outcome.