Neonatal herpes simplex virus infections: where are we now?
Clara Thompson1, Richard Whitley
1Paediatrics, John Radcliffe Children's Hospital, Oxford, UK. clarasisnett@hotmail.com
Advances in Experimental Medicine and Biology
|December 2, 2010
Summary
Neonatal herpes simplex virus (HSV) infection management has improved with antiviral therapies like acyclovir. However, rising acyclovir resistance in HSV isolates poses a significant concern for future treatment strategies.
Area of Science:
- Neonatal infections
- Virology
- Infectious disease epidemiology
Background:
- Neonatal herpes simplex virus (HSV) infection remains a major cause of infant morbidity and mortality.
- Historically, high mortality rates were observed in disseminated and central nervous system HSV disease before antiviral interventions.
- Advances in diagnosis and treatment have significantly improved outcomes for affected neonates.
Purpose of the Study:
- To review current advances in the diagnosis and treatment of neonatal HSV infections.
- To highlight the impact of antiviral therapies on survival and developmental outcomes.
- To address emerging concerns regarding antiviral resistance in neonatal HSV.
Main Methods:
- Review of historical data on neonatal HSV outcomes.
- Analysis of the impact of antiviral therapies (vidarabine, acyclovir) on survival rates.
- Evaluation of diagnostic advancements, including polymerase chain reaction (PCR).
- Assessment of current treatment strategies, including oral suppression therapy.
- Examination of emerging trends in acyclovir-resistant HSV isolates.
Main Results:
- Antiviral therapy, initially vidarabine and later acyclovir, has dramatically improved survival rates and long-term developmental outcomes for neonatal HSV.
- Polymerase chain reaction (PCR) enables earlier HSV identification and serves as a quantitative treatment guide.
- Prolonged oral suppression therapy is being explored to reduce recurrent disease incidence.
- There is a growing concern regarding increasing reports of acyclovir-resistant HSV isolates in neonates undergoing prolonged treatment.
Conclusions:
- Antiviral therapies have transformed the prognosis of neonatal HSV infections.
- Early diagnosis via PCR aids in timely and quantitative treatment.
- The emergence of acyclovir-resistant HSV strains necessitates careful monitoring and may require alternative therapeutic approaches.
- Further research into managing acyclovir resistance is crucial for optimizing neonatal HSV care.
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