Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • Log out
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • Log out
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Natural History of Neonatal Herpes Simplex Virus Infections in the Acyclovir Era

David W. Kimberlin, Chin-Yu Lin, Richard F. Jacobs, Dwight A. Powell, Lisa M. Frenkel, William C. Gruber, Mobeen Rathore, John S. Bradley, Pamela S. Diaz, Mary Kumar, Ann M. Arvin, Kathleen Gutierrez, Mark Shelton, Leonard B. Weiner, John W. Sleasman, Teresa Murguı́a de Sierra, Seng-Jaw Soong, Jan Kiell, Fred D. Lakeman, Richard J. Whitley and the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Groupa
Pediatrics August 2001, 108 (2) 223-229; DOI: https://doi.org/10.1542/peds.108.2.223
David W. Kimberlin
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Chin-Yu Lin
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard F. Jacobs
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Dwight A. Powell
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lisa M. Frenkel
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William C. Gruber
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mobeen Rathore
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John S. Bradley
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pamela S. Diaz
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mary Kumar
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ann M. Arvin
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathleen Gutierrez
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mark Shelton
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Leonard B. Weiner
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John W. Sleasman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Teresa Murguı́a de Sierra
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Seng-Jaw Soong
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jan Kiell
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fred D. Lakeman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard J. Whitley
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
a
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

Objective. During the 2 decades in which effective antiviral therapies have been available for neonatal herpes simplex virus (HSV) disease, changes have been documented not only in the outcomes of infected infants, but also in the natural history of the disease itself. Numerous studies previously have reported that early institution of antiviral therapy is beneficial to the outcome of the disease. The objective of this study was to provide an update of neonatal HSV disease to identify means by which future improvements in the management of HSV-infected neonates can be made.

Design/Methods. Neonates enrolled in 2 studies of parenteral acyclovir for the treatment of neonatal HSV disease provided the data source. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group conducted the studies between 1981 and 1997. A total of 186 patients are summarized, all of whom were treated with acyclovir. Demographic and clinical characteristics of these patients are reported.

Results. Comparisons between patients treated in the periods between 1981–1988 and 1989–1997 according to extent of disease revealed that the mean time between the onset of disease symptoms and initiation of therapy has not changed significantly from the early 1980s to the late 1990s. Of all patients evaluated, 40% had fetal scalp monitors during the delivery process. A significant minority of patients did not have skin vesicles at the time of their presentation and did not develop them during the acute HSV disease (39% of patients with disseminated disease; 32% of patients with central nervous system [CNS] disease; and 17% of patients with skin, eye, and/or mouth disease). Among patients with CNS disease, mortality was associated with prematurity. Among patients with disseminated HSV disease treated with acyclovir at 30 mg/kg/d, mortality was associated with aspartate transaminase elevations of ≥10 times the upper limit of normal at the time of initiation of acyclovir therapy. Mortality was also associated with lethargy at initiation of antiviral therapy for patients with disseminated disease. Patients' morbidity status was associated with the extent of disease (skin, eye, and/or mouth disease vs CNS vs disseminated). For those patients with CNS disease, morbidity was also associated with seizures at initiation of antiviral therapy.

Conclusion. Data presented in the current comparison of neonatal HSV disease over the 2 periods (1981–1988 vs 1989–1997) demonstrate that no progress has been made in decreasing the interval between onset of HSV symptoms and initiation of antiviral therapy. Additional strides in the improvement of disease outcome may occur only if the interval between onset of symptoms and initiation of therapy is shortened. The means by which this will be accomplished lie in increased consideration of neonatal HSV infections in acutely ill infants. Specific data and recommendations to facilitate this goal are contained within.

  • newborn
  • herpes simplex virus
  • acyclovir
  • Received September 1, 2000.
  • Accepted December 11, 2000.
  • Copyright © 2001 American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 108, Issue 2
1 Aug 2001
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Natural History of Neonatal Herpes Simplex Virus Infections in the Acyclovir Era
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Natural History of Neonatal Herpes Simplex Virus Infections in the Acyclovir Era
David W. Kimberlin, Chin-Yu Lin, Richard F. Jacobs, Dwight A. Powell, Lisa M. Frenkel, William C. Gruber, Mobeen Rathore, John S. Bradley, Pamela S. Diaz, Mary Kumar, Ann M. Arvin, Kathleen Gutierrez, Mark Shelton, Leonard B. Weiner, John W. Sleasman, Teresa Murguı́a de Sierra, Seng-Jaw Soong, Jan Kiell, Fred D. Lakeman, Richard J. Whitley, the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Groupa
Pediatrics Aug 2001, 108 (2) 223-229; DOI: 10.1542/peds.108.2.223

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Natural History of Neonatal Herpes Simplex Virus Infections in the Acyclovir Era
David W. Kimberlin, Chin-Yu Lin, Richard F. Jacobs, Dwight A. Powell, Lisa M. Frenkel, William C. Gruber, Mobeen Rathore, John S. Bradley, Pamela S. Diaz, Mary Kumar, Ann M. Arvin, Kathleen Gutierrez, Mark Shelton, Leonard B. Weiner, John W. Sleasman, Teresa Murguı́a de Sierra, Seng-Jaw Soong, Jan Kiell, Fred D. Lakeman, Richard J. Whitley, the National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Groupa
Pediatrics Aug 2001, 108 (2) 223-229; DOI: 10.1542/peds.108.2.223
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • METHODS
    • RESULTS
    • DISCUSSION
    • ACKNOWLEDGMENTS
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Evaluation for Neonatal HSV in Infants Undergoing Workup for Serious Bacterial Infection: A 5-Year Retrospective Review
  • Neonatal Herpes Simplex Virus: The Long Road to Improved Outcomes
  • Personalized viral genomic investigation of herpes simplex virus 1 perinatal viremic transmission with dual fatality
  • Reducing Variability in the Infant Sepsis Evaluation (REVISE): A National Quality Initiative
  • Using Quality Improvement to Implement a Standardized Approach to Neonatal Herpes Simplex Virus
  • Laboratory Diagnosis of Neonatal Herpes Simplex Virus Infections
  • Genotypic and phenotypic diversity within the neonatal HSV-2 population
  • Neonatal Herpes Simplex Virus Infection Among Medicaid-Enrolled Children: 2009-2015
  • Neonatal Herpes Simplex Virus Infections: New Data, Old Conundrum
  • Zika Fetal Neuropathogenesis: Etiology of a Viral Syndrome
  • Genotypic and Phenotypic Diversity of Herpes Simplex Virus 2 within the Infected Neonatal Population
  • Risk Stratification of Febrile Infants <=60 Days Old Without Routine Lumbar Puncture
  • Well-Appearing Newborn With a Vesiculobullous Rash at Birth
  • Herpes Simplex Virus Infection in Infants Undergoing Meningitis Evaluation
  • Neonatal Herpes Simplex Virus Infection
  • Impact of a Rapid Herpes Simplex Virus PCR Assay on Duration of Acyclovir Therapy
  • Multicenter Evaluation of BioFire FilmArray Meningitis/Encephalitis Panel for Detection of Bacteria, Viruses, and Yeast in Cerebrospinal Fluid Specimens
  • The Type I Interferon Response Determines Differences in Choroid Plexus Susceptibility between Newborns and Adults in Herpes Simplex Virus Encephalitis
  • Case 3: Neonate Presenting with Acute Liver Failure and Shock
  • Testing and Empiric Treatment for Neonatal Herpes Simplex Virus: Challenges and Opportunities for Improving the Value of Care
  • HSV targeting of the host phosphatase PP1{alpha} is required for disseminated disease in the neonate and contributes to pathogenesis in the brain
  • High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study
  • Herpes Simplex Viruses 1 and 2
  • The incidence and presentation of neonatal herpes in a single UK tertiary centre, 2006-2013
  • Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments
  • Clinical and Laboratory Characteristics of Disseminated Herpes Simplex Virus Infection in Neonates
  • Management of neonatal herpes simplex virus infection and exposure
  • Early-Onset Neonatal Sepsis
  • Guidance on Management of Asymptomatic Neonates Born to Women With Active Genital Herpes Lesions
  • Neonatal Herpes Encephalitis Caused by a Virologically Confirmed Acyclovir-Resistant Herpes Simplex Virus 1 Strain
  • Pathogenesis of Neonatal Herpes Simplex 2 Disease in a Mouse Model Is Dependent on Entry Receptor Expression and Route of Inoculation
  • Delayed Acyclovir Therapy and Death Among Neonates With Herpes Simplex Virus Infection
  • Neonatal sepsis: A, B, C-don't ever forget herpes
  • Neonatal Herpes Infection: Case Report and Discussion
  • Congenital Infections, Part I: Cytomegalovirus, Toxoplasma, Rubella, and Herpes Simplex
  • Skin Ulcerations in a Preterm Newborn
  • Herpetic neonatal pustular rash
  • Neonatal Herpes in Premature Infants: A Special Problem
  • Herpes Simplex Virus Infections in Preterm Infants
  • Neonatal Herpes Simplex Virus Infections in Canada: Results of a 3-Year National Prospective Study
  • Herpes Simplex Virus Central Nervous System Relapse During Treatment of Infantile Spasms With Corticotropin
  • Challenges in the Diagnosis and Management of Neonatal Herpes Simplex Virus Encephalitis
  • Herpes Simplex Virus Encephalitis During Suppressive Therapy With Acyclovir in a Premature Infant
  • Etiology of Neonatal Seizures
  • Herpes Simplex Virus
  • Neonatal Herpes Simplex Infection
  • Use of Herpes Type-specific Serology to Prevent Neonatal Herpes Simplex Virus Infection
  • Blocking Immune Evasion as a Novel Approach for Prevention and Treatment of Herpes Simplex Virus Infection
  • Relapse of neonatal herpes simplex virus infection
  • Bioluminescence Imaging Reveals Systemic Dissemination of Herpes Simplex Virus Type 1 in the Absence of Interferon Receptors
  • Risk Factors for Perinatal Transmission of HSV
  • The potential role of suppressive therapy for sex partners in the prevention of neonatal herpes: a health economic analysis
  • Safety and Efficacy of High-Dose Intravenous Acyclovir in the Management of Neonatal Herpes Simplex Virus Infections
  • Google Scholar

More in this TOC Section

  • Evaluation of an Emergency Department High-risk Bruising Screening Protocol
  • National Perinatal Hepatitis B Prevention Program: 2009–2017
  • Time to First Onset of Chest Binding–Related Symptoms in Transgender Youth
Show more Article

Similar Articles

Subjects

  • Infectious Disease
    • Infectious Disease
  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics