Preventing Herpes Simplex Virus in the Newborn

Pinninti, Swetha; Kimberlin, David W.

doi:10.1016/j.clp.2014.08.012

Cited by 57 publications

(71 citation statements)

References 34 publications

(54 reference statements)

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“…Nevertheless, our study showed no significant seasonal difference in TOX‐IgM prevalence. To avoid congenital defects, it is advised that nonpregnant woman with an acute TOX infection should wait for at least 6 months before being pregnant …”

Section: Discussionmentioning

confidence: 99%

Seasonal influence on TORCH infection and analysis of multi‐positive samples with indirect immunofluorescence assay

Chen

Liu

Shi

et al. 2019

Clinical Laboratory Analysis

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BackgroundTORCH including the pathogens of Toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV), and herpes simplex virus (HSV) causes intrauterine infections and poses a worldwide threat to women especially in pregnancy. In this study, we described the seasonal difference in TORCH infection and analyzed the anti‐TORCH IgM multipositive serum samples by the indirect immunofluorescence assays (IFA).MethodsTo observe the seasonal influence of the anti‐TORCH IgG and IgM antibodies, a retrospective study was conducted with 10 669 women (20–40 y old) before pregnancy from August 2016 to July 2017. Totally 199 ELISA anti‐TORCH IgM multipositive serum samples were further tested by IFAs for false‐positive analysis.ResultsThe prevalence of positive HSV1‐IgM, RV‐IgM, HSV2‐IgM, CMV‐IgM, and TOX‐IgM in the present population was 6.30%, 2.55%, 1.94%, 1.24%, and 0.67%, respectively. Additionally, the prevalence of positive RV‐IgM, CMV‐IgM, and HSV1‐IgM was statistically different among four seasons, with the highest positive rates of RV‐IgM (4.12%) in autumn, CMV‐IgM (1.75%) in summer, and HSV1‐IgM (7.53%) in winter. The confirmatory IFAs showed that the positive rates of RUV‐IgM, CMV‐IgM, and HSV2‐IgM were significantly different from those in ELISA screening experiments. Interestingly, only 32.7% (65/199) of the TORCH IgM multipositive results were consistent with those by the IFA, indicating that cross‐reaction caused false positives were common in ELISA IgM antibody screening.ConclusionThe TORCH infection displayed different prevalence among four seasons in our 12‐month retrospective study. The IgM multipositives by ELISA screening may need further confirmation analysis due to its relatively high cross‐reaction rate.

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Section: Discussionmentioning

confidence: 99%

Seasonal influence on TORCH infection and analysis of multi‐positive samples with indirect immunofluorescence assay

Chen

Liu

Shi

et al. 2019

Clinical Laboratory Analysis

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“…1,17 The HSV cultures might not be evaluated at laboratories within all institutions, requiring specimens to be sent for outside assessment. Culture positivity is not required to initiate treatment.…”

Section: Diagnosismentioning

confidence: 99%

“…Skin eyes, and mouth disease; CNS disease; or disseminated disease may have DNAemia or viremia, resulting in positive blood HSV PCR for an extended period of time, curbing serial use as a methodology for therapeutic response. 1,11,17,[19][20][21] Laboratory assessment should take place immediately in all suspected and symptomatic neonates, in conjunction with intravenous pharmacotherapy. If a neonate is born to a mother with suspected HSV genital lesions and the neonate is asymptomatic, laboratory assessment should be obtained 24 hours after birth.…”

Section: Diagnosismentioning

confidence: 99%

Neonatal Herpes Simplex Viral Infections and Acyclovir: An Update

Harris¹,

Holmes²

2017

The Journal of Pediatric Pharmacology and Therapeutics

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Neonatal herpes simplex virus (HSV) infections have high morbidity and mortality rates. Optimization of treatment and prevention strategies are imperative to improve the care and outcomes of neonates infected with HSV. Management of HSV includes reducing neonatal transmission, treating acute infections, and limiting adverse neurodevelopmental outcomes and future cutaneous outbreaks after acute infections. Transmission risk may be affected by route of delivery and maternal suppressive therapy. Neonatal HSV infections are divided into 3 categories: localized skin, eyes, or mouth; localized central nervous system; or disseminated infections. Parenteral acyclovir, the pharmacologic agent of choice, is used when treating each type of infection. However, dosage strategies and durations of therapy may vary based on disease state severity, presentation, and patient characteristics. Oral acyclovir may be used as suppressive therapy after acute treatment completion in specific neonatal populations, reducing long-term adverse neurodevelopmental outcomes and future skin eruptions. The mortality rate remains high even with treatment.

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“…The recent increase in genital HSV-1 incidence among women of childbearing age, particularly in developed nations, suggests that the burden of neonatal infection will continue to rise (1,5). While some infected infants exhibit only superficial infection limited to the skin, eyes, or mouth (SEM disease), about half develop invasive systemic (disseminated disease) or central nervous system (CNS disease) infections associated with significant morbidity and mortality (6,7). Currently, the antiviral medication acyclovir is the standard therapy for all forms of neonatal HSV disease.…”

Section: Introductionmentioning

confidence: 99%

Genotypic and phenotypic diversity within the neonatal HSV-2 population

Akhtar

Bowen

Renner

et al. 2018

Preprint

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Neonates infected with herpes simplex virus (HSV) at the time of birth can have different courses of clinical disease. Approximately half of those infected display manifestations limited to the skin, eyes, or mouth (SEM disease, 45%). However, others develop invasive infections that spread systemically (disseminated, 25%) or to the central nervous system (CNS, 30%); both of which are associated with significant morbidity and mortality. The viral and/or host factors that predispose a neonate to these invasive forms of HSV infection are not known. To define the level of viral diversity within the neonatal population we evaluated ten HSV-2 isolates cultured from neonates with a range of clinical presentations. To assess viral fitness independent of host immune factors, we measured viral growth characteristics of each isolate in cultured cells. We found that HSV-2 isolates displayed diverse in vitro phenotypes. Isolates from neonates with CNS disease were associated with larger average plaque size and enhanced spread through culture, with isolates derived directly from the cerebrospinal fluid (CSF) exhibiting the most robust growth characteristics. We then sequenced the complete viral genomes of all ten neonatal HSV-2 isolates, providing the first insights into HSV genomic diversity in this clinical setting.We found extensive inter-host variation between isolates distributed throughout the HSV-2

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Preventing Herpes Simplex Virus in the Newborn

Cited by 57 publications

References 34 publications

Seasonal influence on TORCH infection and analysis of multi‐positive samples with indirect immunofluorescence assay

Seasonal influence on TORCH infection and analysis of multi‐positive samples with indirect immunofluorescence assay

Neonatal Herpes Simplex Viral Infections and Acyclovir: An Update

Genotypic and phenotypic diversity within the neonatal HSV-2 population

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