Jeffries D J
Department of Virology, St. Bartholomew's Hospital, London, U.K.
Scand J Infect Dis Suppl. 1991;80:21-6.
Herpes simplex viruses type 1 (buccal) and type 2 (genital) present a serious threat to neonates. Infection may occur in utero, by transplacental or ascending infection, by exposure to genital lesions during delivery, or postnatally from relatives or attendants. Antiviral drugs, vidarabine and acyclovir are of equal efficacy and toxicity when used in infants with herpes simplex infections. Transplacental infection during early pregnancy is a very rare cause of congenital abnormality but there have been no recommendations for intervention. Most neonatal infections are acquired from the mother during delivery. Antepartum screening for virus excretion is of no value in predicting exposure at delivery and should not be performed. Caesarean section should be reserved for women who have active lesions at delivery. Even if active lesions are present, in women with a history of recurrent herpes, the risks to the infant are low. Prophylactic acyclovir during pregnancy cannot be recommended until evidence of safety and efficacy has been obtained from controlled trials. Staff should be alert to the dangers of postnatal infection and measures should be taken to exclude, or reduce virus excretion from, staff members or visitors who have orolabial or cutaneous herpes lesions.
1型单纯疱疹病毒（口腔型）和2型单纯疱疹病毒（生殖器型）对新生儿构成严重威胁。感染可在子宫内发生，通过胎盘或上行感染、分娩时接触生殖器病变，或在出生后由亲属或护理人员传播。抗病毒药物阿糖腺苷和阿昔洛韦用于单纯疱疹感染婴儿时，疗效和毒性相当。妊娠早期的胎盘感染是先天性异常的非常罕见的原因，但尚无干预建议。大多数新生儿感染是在分娩时从母亲那里获得的。产前筛查病毒排泄对预测分娩时的接触情况没有价值，不应进行。剖宫产应仅用于分娩时有活动性病变的妇女。即使存在活动性病变，对于有复发性疱疹病史的妇女，婴儿的感染风险也较低。在从对照试验中获得安全性和有效性证据之前，不建议在孕期使用阿昔洛韦进行预防。工作人员应警惕产后感染的危险，并应采取措施排除或减少有口腔或皮肤疱疹病变的工作人员或访客的病毒排泄。
