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
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).