Neonatal Herpes Simplex Virus Infections
Division of Pediatric Infectious Diseases, The University of Alabama at Birmingham, 1600 Seventh Avenue South, CHB 308, Birmingham, AL 35233, USA. Pediatric Clinics of North America
(Impact Factor: 2.12).
04/2013; 60(2):351-365. DOI: 10.1016/j.pcl.2012.12.005
Neonatal herpes simplex virus infections are uncommon, but because of the morbidity and mortality associated with the infection they are often considered in the differential diagnosis of ill neonates. The use of polymerase chain reaction for diagnosis of central nervous system infections and the development of safe and effective antiviral therapy has revolutionized the diagnosis and management of these infants. Initiation of long-term antiviral suppressive therapy in these infants has led to significant improvement in morbidity. This article summarizes the epidemiology of neonatal herpes simplex virus infections and discusses clinical presentation, diagnosis, management, and follow up of infants with neonatal herpes disease.
Available from: M. H. Puranen
- "Theoretically , in utero transmission of HPV can occur hematogenously , by semen at fertilization , or as an ascendant infection of the mother . It is known that HBV , CMV , HSV , parvo , and rubella virus infections can be transmitted from the mother to the child in utero ( Mounts and Shah , 1984 ; Matero and Sever , 1990 ; Whitley , 1993 ; Treadwell , 1994 ) . So far , hematogenous HPV transmission has been considered unlikely , because HPV is known to multiply locally at the site of entry on the skin or mucous membranes , and there has been no proof of disseminated HPV viremia ( Mounts and Shah , 1984 ) . "
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ABSTRACT: To date, more than 100 types of human papillomavirus (HPV) have been identified. In the past 20 years, there has been an increasing interest in HPVs because of their potential role in the pathogenesis of malignant tumors. HPV infections are known to affect predominantly adult, sexually active age groups, whereas skin warts, at various anatomic sites, are usually associated with younger individuals. The modes of viral transmission in children remain controversial, including perinatal transmission, auto- and hetero-inoculation, sexual abuse, and, possibly, indirect transmission via fomites. Recent studies on perinatal infection with HPV have been inconclusive. It is still unclear how frequently perinatal infection progresses to clinical lesions, whether genital, laryngeal, or oral. Conflicting reports have been published on the prevalence of HPV infections in children. The current consensus is, however, that newborn babies can be exposed to cervical HPV infection of the mother. The detection rate of HPV DNA in oral swabs of newborn babies varies from 4% to 87%. The concordance of HPV types detected in newborn babies and their mothers is in the range of 57% to 69%, indicating that the infants might acquire the HPV infection post-natally from a variety of sources. HPV antibodies have been detected in 10% to 57% of the children, and there is usually no correlation between seropositivity and the detection of HPV DNA in either the oral or the genital mucosa. There is also evidence that transmission in utero or post-natal acquisition is possible. The mode of in utero transmission remains unknown, but theoretically the virus could be acquired hematogenously, by semen at fertilization, or as an ascending infection in the mother. The understanding of viral transmission routes is important, particularly because several vaccination programs are being planned worldwide. The serologic response to HPV detected in different populations of young women or women at risk of cervical cancer might be due to genital infections, but the possibility that HPV infection has been acquired earlier in life through the oral mucosa or respiratory tract cannot be ruled out.
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ABSTRACT: Previous studies reported controversial results regarding the possible association of recurrent genital herpes during pregnancy
with a higher risk of preterm birth/low birth weight in newborns. Thus, birth outcomes of mothers with prospective and medically
recorded symptomatic recurrent genital herpes confirmed by serological examination and of mothers without genital herpes were
compared in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities. Our
results showed that of 38,151 newborn infants, 86 (0.23%) had mothers with symptomatic recurrent genital herpes confirmed
by serological examination during pregnancy. The rate of preterm births (14.0% vs. 9.2%) was higher in babies born to mothers
with symptomatic recurrent genital herpes (OR with 95% CI: 1.7, 1.0–3.1) and this increase showed a trimester dependence with
the highest rate in the third trimester (23.5%; OR with 95% CI: 2.6, 1.5–4.5). In conclusion, clinically diagnosed recurrent
genital herpes during the third trimester of pregnancy associated with high risk for preterm birth.
KeywordsRecurrent genital herpes–Gestational age at delivery–Preterm birth
Available from: Marc Steben
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