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Neonatal herpes simplex virus infections

R J Whitley1

  • 1Department of Pediatrics, Microbiology, and Medicine, University of Alabama, Birmingham.

Journal of Medical Virology
|January 1, 1993
PubMed
Summary
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Neonatal herpes simplex virus infections impact 1 in 3,500 births. Antiviral therapies like acyclovir significantly reduce mortality and improve outcomes for affected newborns.

Area of Science:

  • Neonatal infections
  • Virology
  • Pediatric infectious diseases

Background:

  • Neonatal herpes simplex virus (HSV) infections pose a significant health risk in the United States, affecting approximately 1 in 3,500 deliveries.
  • Without antiviral treatment, neonatal HSV infections are associated with substantial morbidity and mortality.
  • Disease presentation varies, including disseminated disease, encephalitis, and localized skin, eye, or mouth infections, influencing prognosis.

Purpose of the Study:

  • To evaluate the effectiveness of antiviral therapy in managing neonatal herpes simplex virus infections.
  • To analyze outcomes based on disease classification (disseminated, encephalitis, localized).
  • To discuss the impact of current and potential future antiviral treatments on neonatal herpes outcomes.

Main Methods:

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  • Review of existing data on neonatal herpes simplex virus infections.
  • Analysis of outcomes associated with different disease classifications (skin, eye, mouth; encephalitis; disseminated).
  • Evaluation of the efficacy of acyclovir and vidarabine in treating neonatal herpes.

Main Results:

  • Antiviral therapy has virtually eliminated mortality for localized (skin, eye, mouth) neonatal herpes, though 5% may experience long-term neurologic sequelae.
  • For neonatal herpes encephalitis, mortality has decreased to approximately 15%, with nearly 50% of survivors developing normally by age 3.
  • In disseminated neonatal herpes, mortality remains high at 50%, but approximately 85% of survivors achieve normal development.

Conclusions:

  • Acyclovir and vidarabine are effective in treating neonatal herpes simplex virus infections.
  • Antiviral therapy has dramatically improved survival rates and neurological outcomes for affected neonates.
  • Further advancements in antiviral medications with enhanced central nervous system penetration hold promise for improving outcomes in severe neonatal herpes cases.