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Oral Acyclovir Benefits Babies With HSV
Neonatal herpes simplex virus (HSV) occurs primarily when a mother who has genital herpes transmits it to the baby, says David Kimberlin, M.D., UAB professor of pediatrics and president-elect of the Pediatric Infectious Diseases Society.
About one in 3,000 live births in the United States result in the baby having neonatal HSV; it is very rare, but it can be devastating, Kimberlin says.
Previously, the Collaborative Antiviral Study Group (CASG), a National Institute of Allergy and Infectious Diseases-sponsored organization housed at UAB and led by UAB researcher and professor Richard J. Whitley, M.D., discovered that babies treated intravenously with the antiviral drug acyclovir had improved mortality. But the CASG suspected that HSV could still be causing problems for these infants, and that additional doses of acyclovir might provide additional benefit.
Our thought was there might be ongoing damage, a sub-clinical replication of the virus within the brain, and that damage might result in worse outcomes over time, says Kimberlin, who is a co-principal investigator for the CASG and lead author of the new study.
In two parallel, identical, placebo-controlled trials, 19 academic medical centers involved in the CASG, including UAB, enrolled 74 infants with HSV disease. The groups were separated into those with central nervous system (CNS) involvement and those with skin, eye and mouth disease. Babies with CNS involvement can suffer brain damage; babies with skin, eye and mouth, while neurologically unharmed, are affected by skin lesions.
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