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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: University of Alabama-Birmingham Researchers Say Babies with Herpes Need More Medication
Hannah Wolfson
October 11, 2011
Birmingham News (10.06.11) - Tuesday, October 11, 2011

Infants surviving neonatal herpes simplex virus disease with central nervous system (CNS) involvement had improved outcomes on six months of oral acyclovir in addition to traditional therapy, a new study shows. About a quarter of women have HSV, and many do not know they are infected.

"These are little babies and they should not have to face such a challenging start to their lives, and if we have a way that we can improve the likelihood of avoiding that, we should work on it," said lead study author David Kimberlin, president- elect of the Pediatric Infectious Diseases Society. "When it does occur, not only is it devastating for the babies, it can be devastating for the parents." The study involved 74 neonates with HSV at 19 hospitals. All the babies received the regular two to three weeks of IV acyclovir. After completing the IV regimen, infants were randomly assigned either to oral acyclovir or placebo, three times daily for six months. Investigators then checked the infants' mental development when the babies were a year old.

Far more of the babies with CNS involvement who received oral acyclovir, 69 percent, did well on their 1-year neurological tests. Just 33 percent of those on placebo had normal neurological development, whereas 33 percent were severely impaired. Oral acyclovir did not make much difference in neurological testing for babies with skin, eye, and mouth but not CNS involvement, but the drug did reduce the likelihood of skin recurrence.

Further research will focus on diagnosing HSV in pregnant women as well as on evaluating a new drug for use with IV acyclovir, said Kimberlin, who is a UAB pediatrics professor.

The study, "Oral Acyclovir Suppression and Neurodevelopment After Neonatal Herpes," was published in the New England Journal of Medicine (2011;365:1284-1292).