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HSV rates soar among Medicaid-insured neonates
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New study results show that neonatal herpes simplex virus infections increased by 56% every year between 2009 and 2015 among children who were insured through Medicaid, resulting in one infection in every 1,886 births.
“Experts have detected anecdotally that an increase in neonatal HSV incidence has occurred over the past decade,” Sanjay Mahant, MD, FRCPC, MSc, a staff pediatrician at The Hospital for Sick Children and associate professor of pediatrics at the University of Toronto, and colleagues wrote in Pediatrics. “More younger women are now susceptible to primary HSV-1 infection as they enter adolescence, and oral sex practices among adolescents and young adults have increased over the past 2 decades.”
The researchers wrote that these factors could increase the rates of both primary and nonprimary HSV-1 infection among women of childbearing ages and therefore result in higher rates of neonatal HSV. They noted that transmission rates after exposure and during delivery increase from 2% in recurrent infection to 25% and 60% in nonprimary and primary infections, respectively.
Mahant and colleagues conducted a retrospective longitudinal cohort study using data from a multistate Medicaid claims database. The study examined 2,107 births from 2009 to 2015. The researchers said HSV infection was identified in 900 of these neonates, with a corrected incidence rate of 4.5 (95% CI, 4.2-4.8) per 10,000 births. The yearly disease incidence increased 56% — from 3.4 per 10,000 births in 2009 to 5.3 per 10,000 births in 2015 (P < .001), they said.
Of the 900 neonates with HSV infection, 54 (6%) died during the index hospitalization, but there was no increase in the yearly mortality rate.
Mahant and colleagues obtained follow-up data for 692 infants. Nearly half (45.7%) of these infants had an ED visit during the study period, and 16.2% were readmitted to the hospital. At follow-up, $60,620,431 was paid for care overall, with a median cost of $87,602 per patient.
“Infants with neonatal HSV should receive comprehensive, coordinated care after diagnosis,” the researchers wrote. “Public health strategies that are targeted on disease prevention and early diagnosis and treatment are needed.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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