From the Infectious Diseases Unit, Royal Children's Hospital Melbourne.
Department of Paediatrics, The University of Melbourne.
Pediatr Infect Dis J. 2021 May 1;40(5S):S16-S21. doi: 10.1097/INF.0000000000002846.
Neonatal herpes simplex virus (HSV) infection carries significant morbidity and mortality. In contrast to perinatal exposure, there are no clear guidelines for the management of postnatal HSV exposure. This review focuses on the risk of HSV infection following postnatal exposure and suggests an approach to management. While many infants are protected by transplacentally transferred maternal anti-HSV antibodies, infants of seronegative mothers with significant postnatal HSV exposure may be at risk of severe disease. Individual risk assessment, appropriate investigations, and empiric acyclovir treatment should be considered in postnatally exposed newborns, even if asymptomatic. In all cases, close clinical follow-up is indicated, as well as education of families on the symptoms of neonatal HSV disease. Finally, measures to reduce the risk of postnatal HSV infection should be considered, such as discouraging individuals, particularly those with a history of recurrent cold sores, from kissing newborns.
新生儿单纯疱疹病毒（HSV）感染具有显著的发病率和死亡率。与围产期暴露不同，对于产后 HSV 暴露尚无明确的管理指南。本综述重点关注产后暴露后 HSV 感染的风险，并提出了一种管理方法。虽然许多婴儿受到胎盘转移的母体抗 HSV 抗体的保护，但对于血清阴性且有大量产后 HSV 暴露的母亲的婴儿，可能有患严重疾病的风险。即使无症状，也应考虑对产后暴露的新生儿进行个体风险评估、适当的检查和经验性阿昔洛韦治疗。在所有情况下，都需要密切临床随访，并对新生儿 HSV 疾病的症状对家属进行教育。最后，应考虑采取措施降低产后 HSV 感染的风险，例如劝阻个体，特别是有复发性唇疱疹病史的个体，不要亲吻新生儿。
