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Neonatal herpes simplex virus infection.

Richard Whitley1

  • 1University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. rwhitley@peds.uab.edu

Current Opinion in Infectious Diseases
|May 29, 2004
PubMed
Summary

Neonatal herpes simplex virus (HSV) infection outcomes are poor, especially with central nervous system disease. Early detection and high-dose acyclovir treatment improve survival rates for affected infants.

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Area of Science:

  • Virology
  • Neonatal Medicine
  • Epidemiology

Background:

  • Neonatal herpes simplex virus (HSV) infection poses a significant threat, with poor outcomes despite antiviral therapies.
  • Disseminated multi-organ infection and central nervous system disease present particular challenges in neonatal HSV management.

Purpose of the Study:

  • To review recent advances impacting the management of neonatal herpes simplex virus infections.
  • To highlight updated understanding of transmission, risk factors, and treatment protocols.

Main Methods:

  • Review of epidemiological investigations on genital herpes in pregnant women.
  • Analysis of treatment outcomes with high-dose acyclovir therapy.

Main Results:

  • Identified key risk factors for neonatal HSV, including first-episode maternal infection in the third trimester and invasive monitoring.
  • Demonstrated that high-dose acyclovir (20 mg/kg every 8 hours for 21 days) significantly reduces mortality in infants with encephalitis or disseminated disease.

Conclusions:

  • Epidemiological studies have identified at-risk pregnancies and methods to decrease maternal-fetal transmission.
  • Cesarean delivery can reduce neonatal HSV incidence when maternal infection is present.
  • Prompt administration of higher-dose, longer-duration acyclovir is recommended for neonatal HSV disease.

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