Related Experiment Video
Updated: Jan 2, 2026
Plaquing of Herpes Simplex Viruses
Published on: November 5, 2021
Neonatal herpes simplex virus infections. Presentation and management
Insights
Neonatal herpes simplex virus (HSV) infection is severe, but antiviral chemotherapy like vidarabine significantly reduces mortality in infants with disseminated or central nervous system (CNS) disease. Localized skin, eye, and mouth (SEM) disease shows excellent outcomes with treatment.
Area of Science:
- Virology
- Neonatal Medicine
- Infectious Diseases
Background:
- Neonatal herpes simplex virus (HSV) infections pose significant risks for infant morbidity and mortality.
- Understanding the presentation, natural history, and outcomes of neonatal HSV is crucial for effective management.
Purpose of the Study:
- To evaluate the effectiveness of antiviral chemotherapy in treating neonatal HSV infections.
- To analyze outcomes based on disease classification: disseminated, central nervous system (CNS), or skin, eye, and mouth (SEM).
Main Methods:
- Analysis of ongoing studies by the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group.
- Classification of neonatal HSV infections into disseminated, localized CNS disease, or localized SEM disease.
- Comparison of vidarabine treatment outcomes against placebo in affected infants.
Main Results:
- Vidarabine administration (15 or 30 mg/kg/day) significantly decreased mortality in infants with disseminated and CNS disease compared to placebo.
- Approximately one-third of infants with disseminated or CNS disease experienced normal development post-treatment.
- Infants with localized SEM disease had no deaths and 88% normal development following treatment.
Conclusions:
- Antiviral therapy, including vidarabine, is effective in managing neonatal HSV infections, particularly reducing mortality in severe cases.
- Outcomes are strongly dependent on the classification and extent of the HSV infection.
- Further research, including studies on acyclovir, is needed to improve treatment outcomes for neonatal HSV.
Abstract:
Neonatal herpes simplex virus (HSV) infections are recognized to be severe because of their association with significant morbidity and mortality. Through ongoing studies performed by the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group, the presentation, natural history, outcome and value of antiviral chemotherapy have been considered. Infants developing neonatal HSV infections can be classified according to the extent of disease, disseminated or localized. Localized infection can be subdivided into either central nervous system (CNS) disease, occurring in 35% of infected infants, or skin, eye and mouth (SEM) disease, in 41% of infants. Disseminated disease accounts for 24% of neonatal HSV infection. Therapeutic outcome depends upon disease classification. Administration of either 15 or 30 mg/kg/day of vidarabine resulted in significantly decreased mortality for infants with life-threatening disseminated and CNS disease as compared to placebo recipients. Approximately one-third of children developed normally following disseminated disease or CNS infection. When disease was localized to the SEM, no death occurred, and 88% of treated infants developed normally. While these data indicate that therapy is effective for management of infants with neonatal HSV infection, improvements are necessary. Hopefully, a study in progress will demonstrate improved outcome with acyclovir treatment.
