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Knowing HSV type helps target treatment of mother and infant
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Using serological and virologic testing for mothers with herpes simplex virus can help refine management options for their newborns, according to a paper published online this month by the AAP’s Committee on Infectious Diseases and the Committee on Fetus and Newborn.
David W. Kimberlin, MD, and Jill Baley, MD, wrote: “women with primary genital HSV infections who are shedding HSV at delivery are 10 to 30 times more likely to transmit the virus to their newborn infants than are women with recurrent HSV infection who are shedding virus at delivery.”
David W. Kimberlin
Knowing the type of maternal HSV infection can help with treatment for the mother and their newborns, according to Kimberlin and Baley. Kimberlin is professor of pediatrics, the Sergio Stagno Endowed Chair in Pediatric Infectious Diseases, and co-director of the division of pediatric infectious diseases at the University of Alabama at Birmingham. He also serves as course director for the annual Infectious Diseases in Children Symposium.
The algorithm suggests that the obstetrician should swab lesions for PCR assay and culture, and then type the results. This information then can be correlated with maternal antibody results to determine the type of maternal infection. If the mother has a history of HSV infection before pregnancy and has lesions at delivery, the algorithm recommends surface HSV cultures and blood PCR. If there was no history, the algorithm recommends also obtaining a serum alanine aminotransferase and beginning acyclovir. The algorithm also recommends that HSV infection classification should be determined.
Disclosure: The study was funded by NIH. The researchers report no relevant financial disclosures.
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