Congenital herpes simpleх: modern approach to prevention, diagnosis, and treatment

Author:

Ivanova R. A.1ORCID,Vasilyev V. V.2ORCID,Rogozina N. V.3ORCID,Grineva A. A.4ORCID,Ushakova G. M.4ORCID

Affiliation:

1. Saint-Petersburg State Pediatric Medical University; First Saint-Petersburg State Medical University named after I.P. Pavlov; Pediatric Research and Clinical Center for Infectious Diseases

2. Pediatric Research and Clinical Center for Infectious Diseases; North-Western State Medical University named after I.I. Mechnikov

3. Saint-Petersburg State Pediatric Medical University; Pediatric Research and Clinical Center for Infectious Diseases

4. Pediatric Research and Clinical Center for Infectious Diseases

Abstract

Among the classic pathogens of congenital infection, herpes simplex viruses type 1 and type 2 play important role. Neonatal herpes develops as a result of antenatal transmission of HSV. The greatest risk occurs with the primary infection of a woman in the late stages of pregnancy. In 85% of cases, genital and neonatal herpes is associated with HSV-2.The purpose of study: to identify the relationship between early manifestations of neonatal herpes and genital herpes during pregnancy for early diagnosis and etiological therapy of the newborn.Materials and methods. The analysis of current clinical recommendations and international consensuses of professional communities in Russia, the USA, and a number of European countries in the management of pregnant women was carried out. The five medical histories of newborn infants with a diagnosis of congenital herpetic infection were analyzed. In the clinical guidelines for the management of normal pregnancy, routine screening of pregnant women for HSV is omitted, however, examination is recommended for symptoms of genital herpes. For the prevention of neonatal herpes, antiviral drugs and caesarean section are used. Congenital herpes develops rarely, proceeds severely with significant residual manifestations in children. Antiviral therapy (Acyclovir) is used for herpetic infection in newborns: with systemic and local infection (eye damage). The analysis showed: despite the recurrent course of genital herpes in 4 out of 5 women during pregnancy, none of the pregnant women had a laboratory examination for HSV, pregnant women did not receive systemic etiological therapy and all deliveries were natural. The absence of preventive measures contributed to the early, during the first three days of life, the development of severe forms of neonatal herpes. In respect that the lack of significant clinical specificity and delayed manifestation, an antenatal anamnesis is important diagnostic criterion for neonatal herpes.

Publisher

Journal of Childrens Infections

Subject

General Medicine

Reference18 articles.

1. Herpes simplex virus. Factsheet WHO. 01.05.2020. https://www.who.int/ru/news-room/fact-sheets/detail/herpes-simplex-virus#

2. Degtyarev D.N., Zaplatnikov A.L., Ryumina I.M. Congenital and perinatal infections. Neonatology: National Guidelines. Ed. N.N. Volodin. Moscow: GEOTAR-Media, 2020: 566—597. (In Russ.)

3. Isakov D.V., V.A. Isakov. Herpes simplex and herpes zoster (clinical features, treatment and prevention): A Guidelines for Medical Doctors. Ed. V.A. Isakov. St. Petersburg: SpecLit, 2021:539. (In Russ.)

4. Decree of the Government of the Russian Federation No. 715 dated 01.12.2004 «On approval of the list of socially significant diseases and the list of diseases that pose a danger to others» (as amended by decrees of the Government of the Russian Federation dated 13.07.2012 No. 710, dated 31.01.2020 No. 66) ... http://government.ru/docs/all/50614/ (In Russ.)

5. James S.H., Kimberlin D.W. Neonatal Herpes Simplex Virus Infection. Infect Dis Clin North Am. 2015 Sep; 29(3):391—400. doi: 10.1016/j.idc.2015.05.001.

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