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Herpes simplex virus: incidence of neonatal herpes simplex virus, maternal screening, management during pregnancy, and HIV

Roberts, Scott

Current Opinion in Obstetrics & Gynecology: April 2009 - Volume 21 - Issue 2 - p 124–130
doi: 10.1097/GCO.0b013e3283294840
Maternal-fetal medicine: Edited by James F. Smith

Purpose of review: Neonatal herpes simplex virus infection is often severe, if not fatal. What is our understanding of the epidemiology of this disease? How is it diagnosed? Would maternal screening for herpes simplex virus-2 (HSV-2) in pregnancy make a difference? Does maternal HSV alter transmission of HIV vertically or horizontally or both? These questions continue to be pursued and unfortunately, there are few clear answers.

Recent findings: A nationally reportable incidence and case definition of neonatal herpes simplex virus is desirable but not yet in effect. Maternal screening for HSV during pregnancy is becoming prevalent but not supported by any national committee or recommendation. Several lines of research have demonstrated HSV expression facilitates HIV transmission. Recently, HSV suppression has been attempted to decrease horizontal transmission of HIV.

Summary: Neonatal herpes simplex virus infection is a rare and serious neonatal illness. The true burden of disease is uncertain. Several recent retrospectively determined incidences identify a case rate of about one per eight thousand live births. HSV reactivation occurs more often than previously thought. Current prophylactic HSV strategies do not decrease horizontal or vertical transmission of HIV-1.

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

Correspondence to Scott W. Roberts, MD, MS, Associate Professor Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9032, USA Tel: +1 214 648 3113; fax: +1 214 648 7262; e-mail: scott.roberts@utsouthwestern.edu

© 2009 Lippincott Williams & Wilkins, Inc.