Identification of Women at Unsuspected Risk of Primary Infection With Herpes Simplex Virus Type 2 During Pregnancy

Kulhanjian, Julie A.; Soroush, Vesta; Au, Deborah S.; Bronza, Rachel N.; Yasukawa, Linda L.; Weylman, Laura E.; Arvin, Ann M.; Prober, Charles G.

doi:10.1097/00006254-199209000-00005

Cited by 20 publications

(26 citation statements)

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“…19,20 Regarding MTCT of HSV, studies have shown 20% to 30% of pregnant women to be seropositive for HSV-2 and that most women with a known history of genital herpes reactivate at least once during the course of a pregnancy. [21][22][23][24] In virologic surveillance of pregnant women with a known history of recurrent genital herpes, the rate of asymptomatic viral shedding at the time of delivery is as high as 1.4%, meaning that perinatal exposure of a newborn to HSV likely occurs more frequently than clinicians are aware. 25 Although the presence of active herpetic genital lesions or Neonatal Herpes Simplex Virus Infection asymptomatic shedding of virions are risk factors in themselves, recurrent HSV infection such as this still constitutes less of a risk for transmission of HSV infection to a newborn than does acquiring a new primary or first-episode infection near the time of delivery.…”

Section: Seroprevalence Of Herpes Simplex Virus Infection and Incidenmentioning

confidence: 99%

Neonatal Herpes Simplex Virus Infection

James

Kimberlin

2015

Infectious Disease Clinics of North America

112

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Section: Seroprevalence Of Herpes Simplex Virus Infection and Incidenmentioning

confidence: 99%

Neonatal Herpes Simplex Virus Infection

James

Kimberlin

2015

Infectious Disease Clinics of North America

112

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“…Pregnant women are at greatest risk of acquiring HSV infection if they are seronegative for HSV-1 and/or HSV-2 and their partner is seropositive [37], a situation that occurs in approximately 10% of couples [57]. Type-specific serological testing can thus be used to identify women at risk of transmitting HSV to their infants [40,51].…”

Section: Indirect Hsv Testingmentioning

confidence: 99%

Diagnosis of genital herpes: the role and place of HSV testing in clinical practice

Strand

2006

Eur Clinics Obstet Gynaecol

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Genital herpes is caused by herpes simplex virus (HSV)-1 and HSV-2. It is an underdiagnosed and undertreated sexually transmitted infection characterised by latency followed by reactivation. The seroprevalence of both types of HSV varies throughout Europe, and HSV-1 is an increasing cause of genital herpes. Transmission is through skin-to-skin contact, and neonatal herpes resulting from transmission during delivery is a particularly serious problem. Diagnosis of genital herpes is not straightforward, and a clinical diagnosis alone is usually insufficient. Correct diagnosis is essential for appropriate management and reduction of transmission. Laboratory diagnosis can be by direct detection of the virus or indirect measurement of antibodies. Direct testing has traditionally been through culture of the virus, but detection of viral nucleic acids by real-time polymerase chain reaction is now considered the gold standard method. Type-specific serological testing based on glycoprotein G also has a role in asymptomatic patients or those with non-specific symptoms and in identifying serodiscordant couples, pregnant women at risk and patients co-infected with HIV and HSV-2. Having made an accurate diagnosis, effective management of genital herpes is by treatment with an oral antiviral agent and patient counselling.

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“…Evidence suggests that the women with highest-risk pregnancies may be the least likely to receive a prenatal HSV screening; 5 of 9 women with primary HSV infection at delivery studied by Brown et al [55] received no prenatal care or prenatal care at an outside facility. Screening of partners may also be difficult: 145% of husbands of pregnant women in a middle-to upper-class private practice obstetrical community refused HSV serological testing [58]. Possible interventions once a pregnant patient is identified at risk for HSV-2 infection are counseling regarding risk reduction, consistent correct condom use, abstinence, or antiviral therapy for the HSV-2-infected sex partner(s).…”

Section: Patients At Increased Risk For Stds and Hiv Infectionmentioning

confidence: 99%