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Hot Topics in Infection and Immunity in Children VII

Volume 697 of the series Advances in Experimental Medicine and Biology pp 221-230

Date:

Neonatal Herpes Simplex Virus Infections: Where Are We Now?

  • Clara ThompsonAffiliated withPaediatrics, John Radcliffe Children’s Hospital
  • , Richard WhitleyAffiliated withPaediatrics, Microbiology, Medicine and Neurosurgery, The University of Alabama Email author 

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Abstract

Neonatal herpes simplex virus (HSV) infection continues to cause significant morbidity and mortality despite advances in diagnosis and treatment. Prior to antiviral therapy, 85% of patients with disseminated HSV disease and 50% of patients with central nervous system disease died within 1 year. The advent of antiviral therapy has dramatically improved the prognosis of neonatal HSV with initially vidarabine and subsequently acyclovir increasing the survival rate of infected neonates and improving long-term developmental outcomes. More recently, polymerase chain reaction has allowed earlier identification of HSV infection and provided a quantitative guide to treatment. Current advances in the treatment of neonatal HSV infections are looking toward the role of prolonged oral suppression therapy in reducing the incidence of recurrent disease. Of concern, however, are increasing reports of acyclovir-resistant HSV isolates in patients following prolonged therapy.