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Neonatal herpes simplex virus infections

R F Jacobs1

  • 1Department of Pediatrics, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock 72202-3591, USA.

Seminars in Perinatology
|April 2, 1998
PubMed
Summary
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Neonatal herpes simplex virus (HSV) infection poses a significant threat to newborns. While mortality has decreased, central nervous system and disseminated disease still have high mortality rates, necessitating further research into effective therapies.

Area of Science:

  • Neonatal infectious diseases
  • Virology
  • Pediatric neurology

Background:

  • Neonatal herpes simplex virus (HSV) infection is a severe condition affecting 1,500-2,200 US infants annually.
  • Recent trends show an increase in skin, eye, and mouth (SEM) disease, stable central nervous system (CNS) disease, and a decline in disseminated infections.

Purpose of the Study:

  • To review the current understanding of neonatal HSV infection, including presentation, outcomes, and treatment efficacy.
  • To identify areas for future research in prophylaxis, diagnosis, and therapy for neonatal HSV.

Main Methods:

  • Review of existing literature and clinical trial data on neonatal HSV infection.
  • Analysis of treatment outcomes for vidarabine versus acyclovir.
  • Evaluation of emerging diagnostic techniques like polymerase chain reaction (PCR).

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Main Results:

  • Mortality rates for CNS (15%) and disseminated (57%) neonatal HSV remain high despite antiviral therapies.
  • Seizures and HSV-2 infection are risk factors for poor outcomes in survivors.
  • Oral acyclovir shows promise for preventing SEM recurrences, but requires further study.

Conclusions:

  • While antiviral therapy has improved outcomes, significant mortality and morbidity persist, particularly in CNS and disseminated forms of neonatal HSV.
  • Further clinical trials are essential for optimizing prophylactic strategies, diagnostic testing, and novel therapeutic approaches, including combination therapies.