Skip to main content

Advertisement

Log in

Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 1: Herpes simplex virus infections

  • Original Investigation
  • Published:
Medical Microbiology and Immunology Aims and scope Submit manuscript

Abstract

Primary herpes simplex virus (HSV) infection may lead to severe illness in pregnancy and may be associated with transplacental virus transmission and fetal infection. The consequences may be abortion, stillbirth and congenital malformations. In neonates, the clinical findings after intrauterine HSV infection are characterized by skin lesions, diseases of the eye and neurologic damage. Herpes genitalis of pregnant women at the time of labor may result in life-threatening neonatal herpes. Currently, neither active nor passive immunization is available to prevent HSV infections during pregnancy and in the newborn infant. Therefore, antiviral treatment using aciclovir and/or valaciclovir must be considered in all primary episodes of genital herpes as well as in neonates who show signs of either infection. Clinical herpes lesions of the genitalia and/or positive test for virus detection at the time of delivery are an indication for cesarean section. However, this surgical intervention may be reduced by suppressive treatment of recurrent genital herpes with aciclovir or valaciclovir.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. American Academy of Pediatrics (2003) Herpes simplex. In: Pickering LK (ed) Red Book: 2003 Report of the Committee on Infectious Diseases, 26th edn. American Academy of Pediatrics, Elk Grove Village, pp 836–843

  2. Andrews EB (1994) Acyclovir does not increase risk in pregnancy. Am Pharm NS34:6

    PubMed  CAS  Google Scholar 

  3. Anonymous (2004). Deutsches Herpes Management Forum. Chemother J 13:27–37

    Google Scholar 

  4. Benador N, Mannhardt W, Schranz D, Braegger C, Fanconi S, Hassan S, Talebzadeh V, Cox J, Suter S (1990) Three cases of neonatal herpes simplex virus infection presenting as fulminant hepatitis. Eur J Pediatr 149:555–559

    Article  PubMed  CAS  Google Scholar 

  5. Benedetti J, Corey L, Ashley R (1994) Recurrence rates in genital herpes after symptomatic first-episode infection. Ann Intern Med 121:847–854

    PubMed  CAS  Google Scholar 

  6. Bergström T, Trybala E (1996) Antigenic differences between HSV-1 and HSV-2 glycoproteins and their importance for type-specific serology. Intervirology 39:176–184

    PubMed  Google Scholar 

  7. Brown ZA (2002) Case study: type-specific HSV serology and the correct diagnosis of first-episode genital herpes during pregnancy. Herpes 9:24–26

    PubMed  Google Scholar 

  8. Brown ZA, Selke S, Zeh J, Kopelman J, Maslow A, Ashley RL, Watts DH, Berry S, Herd M, Corey L (1997) The acquisition of herpes simplex during pregnancy. N Engl J Med 337:509–515

    Article  PubMed  CAS  Google Scholar 

  9. Brown ZA, Vontver LA, Benedetti J, Critchlow CW, Sells CJ, Berry S, Corey L (1987) Effects on infants of a first episode of genital herpes during pregnancy. N Engl J Med 317:1246–1251

    Article  PubMed  CAS  Google Scholar 

  10. Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L (2003) Effect of serologic status and cesarean section on transmission rates of herpes simplex virus from mother to infant. JAMA 289:203–209

    Article  PubMed  Google Scholar 

  11. Chuang T (1988) Neonatal herpes: incidence, prevention and consequences. Am J Prev Med 4:47–53

    PubMed  CAS  Google Scholar 

  12. Donoval BA, Passaro DJ, Klausner JD (2006) The public health imperative for neonatal herpes simplex virus infection surveillance system. Sex Transm Dis 33:170–174

    Article  PubMed  Google Scholar 

  13. Enders G, Miller E (2000) Varicella and herpes zoster in pregnancy and the newborn. In: Arvin AM, Gershon AA (eds) Varicella-zoster virus. Virology and clinical management. University Press, Cambridge, pp 317–347

    Google Scholar 

  14. Fleming DT, McQuillan GM, Johnson RE, Nahmias AJ, Aral SO, Lee FK, St Louis ME (1997) Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med 337:1105–1111

    Article  PubMed  CAS  Google Scholar 

  15. Gray PH, Tudehope DI, Masel J (1992) Cystic encephalomalacia and intrauterine herpes simplex virus infection. Pediatr Radiol 22:529–532

    Article  PubMed  CAS  Google Scholar 

  16. Greenes DS, Rowitch D, Thorne GM, Perez-Atayde A, Lee FS, Goldmann D (1995) Neonatal herpes simplex virus infection presenting as fulminant liver failure. Pediatr Infect Dis J 14:242–244

    PubMed  CAS  Google Scholar 

  17. Hensleigh PA, Andrews WW, Brown Z, Greenspoon J, Yasukawa L, Prober CG (1997) Genital herpes during pregnancy: inability to distinguish primary and recurrent infection clinically. Obstet Gynecol 89:891–895

    Article  PubMed  CAS  Google Scholar 

  18. Hoppen T, Eis-Hübinger AM, Schild RL, Enders G, Hansmann M, Richter M, Bartmann P (2001) Intrauterine herpes-simplex-virus-Infection. Klin Pädiatr 213:63–68

    Article  PubMed  CAS  Google Scholar 

  19. Hutto C, Arvin A, Jacobs R, Steele R, Stagno S, Lyrene R, Willett L, Powell D, Andersen R, Werthammer J, Ratcliff G, Nahmias A, Christy C, Whitley R (1987) Intrauterine herpes simplex virus infection. J Pediatr 110:97–101

    Article  PubMed  CAS  Google Scholar 

  20. Johansson AB, Rassart A, Blum D, Van Beers D, Liesnard C (2004) Lower-limb hypoplasia due to intrauterine infection with herpes simplex virus type 2: possible confusion with intrauterine varicella-zoster syndrome. Clin Infect Dis 38:e57–e62

    Article  PubMed  Google Scholar 

  21. Jones CL (1996) Herpes simplex virus infection in the neonate: Clinical presentation and management. Neonatal Netw 15:11–15

    PubMed  CAS  Google Scholar 

  22. Kimberlin DW (2001) Advances in the treatment of neonatal herpes simplex infections. Rev Med Virol 11:157–163

    Article  PubMed  CAS  Google Scholar 

  23. Kimberlin D, Powell D, Gruber W, Diaz P, Arvin A, Kumar M, Jacobs R, van Dyke R, Burchett S, Soong SJ, Lakeman A, Whitley R, The National Institute of Allergy, Infectious Diseases Collaborative Antiviral Study Group (1996) Administration of oral acyclovir suppressive therapy after neonatal herpes simplex virus disease limited to the skin, eyes and mouth: results of a phase I/II trial. Pediatr Infect Dis J 15:247–254

    Article  PubMed  CAS  Google Scholar 

  24. Kimura H, Futamura M, Ito Y, Ando Y, Hara S, Sobajima H, Nishiyama Y, Morishima T (2003) Relapse of neonatal herpes simplex virus infection. Arch Dis Child Fetal Neonatal Ed 88:F483–F486

    Article  PubMed  CAS  Google Scholar 

  25. Kohl S (1997) Neonatal herpes simplex virus infection. Clin Perinatol 24:129–150

    PubMed  CAS  Google Scholar 

  26. Lissauer TJ, Shaw PJ, Underhill G (1984) Neonatal herpes simplex pneumonia. Arch Dis Child 59:668–670

    Article  PubMed  CAS  Google Scholar 

  27. Mc Geoch DJ, Moss HW, McNab D, Frame MC (1987) DNA sequence and genetic content of HindIII region in the short unique component of the herpes simplex virus type 2 genome: identification of the gene encoding glycoprotein G and evolutionary comparisons. J Gen Virol 68:19–38

    Article  CAS  Google Scholar 

  28. Meerbach A, Sauerbrei A, Meerbach W, Bittrich HJ, Wutzler P (2006) Fatal outcome of herpes simplex virus type 1-induced necrotic hepatitis in a neonate. Med Microbiol Immunol 195:101–105

    Article  PubMed  Google Scholar 

  29. Mertz GJ, Benedetti J, Ashley R, Selke SA, Corey L (1992) Risk factors for the sexual transmission of genital herpes. Ann Intern Med 116:197–202

    PubMed  CAS  Google Scholar 

  30. Overall JC Jr (1994) Herpes simplex virus infection of the fetus and newborn. Pediatr Ann 23:131–136

    PubMed  Google Scholar 

  31. Parish WR (1989) Intrauterine herpes simplex virus infection. Hydranencephaly and a nonvesicular rash in an infant. Int Dermatol 28:397–401

    CAS  Google Scholar 

  32. Peacock JE Jr, Sarubbi FA (1983) Disseminated herpes simplex virus infection during pregnancy. Obstet Gynecol 61:13S–18S

    PubMed  Google Scholar 

  33. Reeves WC, Corey L, Adams HG, Vontver LA, Holmes KK (1981) Risk of recurrence after first episodes of genital herpes. Relation to HSV type and antibody response. N Engl J Med 305:315–319

    PubMed  CAS  Google Scholar 

  34. Rudnick CM, Hoekzema GS (2002) Neonatal herpes simplex virus infections. Am Fam Physician 6:1138–1142

    Google Scholar 

  35. Sauerbrei A, Wutzler P (2004) Serological detection of type-specific IgG to herpes simplex virus by novel ELISAs based on recombinant and highly purified glycoprotein G. Clin Lab 50:425–429

    PubMed  CAS  Google Scholar 

  36. Sheffield JS, Hollier LM, Hill JB, Stuart GS, Wendel GD (2003) Acyclovir prophylaxis to prevent herpes simplex virus recurrence at delivery: a systematic review. Obstet Gynecol 102:1396–1402

    Article  PubMed  CAS  Google Scholar 

  37. Smith JR, Cowan FM, Munday P (1998) The management of herpes simplex virus infection in pregnancy. Br J Obstet Gynecol 105:225–260

    Google Scholar 

  38. Swiss Herpes Management Forum (2004) Swiss recommendations for the management of genital herpes and herpes simplex virus infection in the neonate. Swiss Med Wkly 134:205–214

    Google Scholar 

  39. Vasileiadis GT, Roukema HW, Romano W, Walton JC, Gagnon R (2003) Intrauterine herpes simplex infection. Am J Perinatol 20:55–58

    Article  PubMed  Google Scholar 

  40. Weissenbacher ER, Wutzler P (2002) Empfehlung zur Diagnostik und Therapie des Herpes genitalis der Frau aus der AGI. In: Infektologische Empfehlungen und Leitlinien zur Diagnostik und Therapie in Gynäkologie und Geburtshilfe. Medifact-Publishing, München, pp 81–90

  41. Whitley RJ (1994) Neonatal herpes simplex virus infections: is there a role for immunoglobulin in disease prevention and therapy? Pediatr Infect Dis J 13:432–438

    Article  PubMed  CAS  Google Scholar 

  42. Whitley R (2004) Neonatal herpes simplex virus infection. Curr Opin Infect Dis 17:243–246

    Article  PubMed  Google Scholar 

  43. Whitley R, Arvin A, Prober C, Corey L, Burchett S, Plotkin S, Starr S, Jacobs R, Powell D, Nahmias A et al, The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group (1991) Predictors of morbidity and mortality in neonates with herpes simplex virus infections. N Engl J Med 324:450–454

    Google Scholar 

  44. Wutzler P, Doerr HW, Färber I, Eichhorn U, Helbig B, Sauerbrei A, Brandstädt A, Rabenau HF (2000) Seroprevalence of herpes simplex virus type 1 and type 2 in selected German populations— relevance for the incidence of genital herpes. J Med Virol 61:201–207

    Article  PubMed  CAS  Google Scholar 

  45. Young EJ, Chafizadeh E, Oliveira VL, Genta RM (1996) Disseminated herpes virus infection during pregnancy. Clin Infect Dis 22:51–58

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Sauerbrei.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sauerbrei, A., Wutzler, P. Herpes simplex and varicella-zoster virus infections during pregnancy: current concepts of prevention, diagnosis and therapy. Part 1: Herpes simplex virus infections. Med Microbiol Immunol 196, 89–94 (2007). https://doi.org/10.1007/s00430-006-0031-0

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00430-006-0031-0

Keywords

Navigation