Jury still out on HSV mother-to-child transmission

(29 Oct 2002)

Studies into the safety and efficacy of antiviral suppressive therapy in pregnant women is still ongoing, according to a presentation given at the 18th Congress on Sexually Transmitted Infections (IUSTI - Europe, 12-14 September 2002).

Speaking at a satellite symposium, 'Genital Herpes: progress in prevention' supported by GlaxoSmithKline, Dr David Kimberlin from the University of Alabama in Birmingham, USA, stated that while treatment among neonates has greatly improved, safe use of suppressive antiviral therapy among pregnant women and on the unborn child is unproven.

Neonatal HSV infection is a relatively rare but life-threatening disease for the unborn baby. In the USA alone, it is estimated that one in 2500 births result in neonatal HSV disease. With the prevalence of genital herpes increasing, the occurrence of neonatal HSV is also likely to increase in the future.

Several small studies have investigated the use of aciclovir suppressive therapy during the last weeks of pregnancy. These trials suggest that suppressive therapy decreases the occurrence of genital HSV disease at the time of delivery with an associated decrease in caesarian section rates among women receiving the drug. However, subclinical shedding is not fully suppressed in patients studied to date, suggesting that neonatal transmission is still possible despite antiviral suppression.

"Prevention strategies must therefore focus on women with primary infection," commented Dr Kimberlin to the IHA newsdesk.

If you want to know more about managing herpes in pregnancy, including how to reduce the risk of transmission, see our information leaflet, Herpes Simplex & Pregnancy.





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