Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor

Article Abstract:

Genital herpes infection in a mother can be transmitted to the newborn as it passes through the birth canal. For women who show symptoms of active genital herpes infection at the time of delivery, a caesarian section can prevent the spread of an infection that is potentially fatal to a newborn infant. However, recent studies have found that the majority of neonatal herpes infections result from women who do not have symptoms of genital herpes infection. There is enough virus being shed in these asymptomatic cases to infect the newborn. However, these same studies have also shown that the presence of virus does not guarantee infection, and healthy infants may be born to mothers producing active virus. To identify the factors affecting neonatal herpes infection, 15,923 mothers were assessed, starting in the early stages of labor. Cultures were obtained from the cervix and the external genitalia to determine which women might be producing virus without any symptoms of infection. Live virus was isolated and cultured from 56 women. Of these, serologic studies were completed on 52. The antiherpes antibodies detected in the serologic studies permitted the determination of whether the herpes infection was a first episode or whether it was the reactivation of a previous infection. It was found that 6 of the 18 infants born to women experiencing their first genital herpes infection became infected; one of these babies died. In contrast, only one of 34 babies born to women experiencing a recurrent infection was infected with the virus. A key factor determining the transmission of herpes infection seems to be the presence of antibodies in the mother, and none of the women with antibodies to type 2 herpesvirus transmitted the infection to their offspring. The results indicate that screening pregnant women for antibodies to herpes may not be as effective as screening the partners of herpes-negative women. The herpes-negative female partners of herpes-positive men should be counselled about avoiding the risk of herpes infection, especially during the latter part of pregnancy. The risk to the infant seems to be roughly ten-fold higher in first cases of herpes infection than in reactivated infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Risk factors, Demographic aspects, Infants (Newborn), Newborn infants, Herpes simplex

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Frequency of asymptomatic shedding of herpes simplex virus in women with genital herpes

Article Abstract:

Asymptomatic shedding of the herpes simplex virus (HSV) is when the active virus is present, despite a lack of symptoms; this accounts for a significant number of cases that are sexually transmitted. The frequency of asymptomatic shedding in women with genital herpes is not known; some studies have suggested it is a rare occurrence, while others have found evidence of shedding as much as 50 percent of the time. In the largest study ever conducted with nonpregnant women, 27 volunteers with recurrent symptomatic herpes infection provided cultures. Samples were taken from the external genitalia (vulva), cervix, and vagina. Asymptomatic HSV shedding was detected for one percent of the days the subjects obtained cultures; equal amounts of shedding were seen in the three types of cultures. All the subjects who took samples for more than 100 days had asymptomatic shedding, as did 80 percent of the women who submitted samples for more than 50 days. Only six percent of the subjects who obtained samples for fewer than 25 days had evidence of asymptomatic shedding. The incidence of asymptomatic shedding was not related to the menstrual cycle or to contraceptive use. In conclusion, although the risk is relatively small, all women with recurrent genital HSV infection should be aware that on any given day, they can transmit the virus, even though they are symptom free. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Testing, Prevention, Sexually transmitted disease prevention

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Frequent Recovery of HIV-1 From Genital Herpes Simplex Virus Lesions in HIV-1-Infected Men

Article Abstract:

Genital herpes ulcers may increase the efficiency of HIV transmission. Genital ulcers are commonly caused by herpes simplex virus 2. Researchers tested genital ulcers from 12 HIV-infected men with genital ulcer disease for evidence of the HIV virus. HIV was detected in swabs taken from genital lesions in 25 of 26 herpes outbreaks and 67% of days when ulcer lesions were present. The level of HIV in genital ulcers was approximately twice as high as the blood level in patients. Shedding of HIV through genital ulcers may increase the risk of HIV transmission during sexual activity.

Physiological aspects, HIV infection, HIV infections, HIV patients

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