Effect of maternal herpes simplex virus (HSV) serostatus and HSV type on risk of neonatal herpes.
BACKGROUND
Neonatal herpes simplex virus (HSV) is a rare but devastating disease. We have conducted pooled analyses of data from 3 cohorts to evaluate the effects of maternal HSV serostatus and HSV type on risk of neonatal HSV acquisition and severity.


METHODS
Data from cohorts in Seattle, WA, and Stanford, CA, USA, and Stockholm, Sweden were pooled using Mantel-Haenszel methods.


RESULTS
Seventy-eight infants with documented neonatal HSV and known maternal HSV serostatus were included. The risk of neonatal HSV-2 infection was similar in infants born to HSV seronegative women compared with HSV-1 seropositive women (pooled OR: 1.6; 95% CI: 0.6-4.0). The odds of neonatal HSV infection was increased in the presence of exposure to maternal HSV-1 versus HSV-2 (adjusted pooled OR: 19.2; 95% CI: 5.8-63.6). An elevated odds of disseminated HSV in infants born to women with newly acquired genital herpes was observed in Stockholm (OR=13.5; 95% CI: 1.4-630), but not in Seattle or Stanford.


CONCLUSIONS
Our results suggest that maternal HSV-1 antibody offers little, if any, protection against neonatal HSV-2 infection. During reactivation, HSV-1 appears more readily transmissible to the neonate than HSV-2, a concerning finding given the rising frequency of genital HSV-1 infection.
Brown
Elizabeth L
EL
Department of Epidemiology, University of Washington, Seattle, WA 98122, USA, and Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden.
Gardella
Carolyn
C
Malm
Gunilla
G
Prober
Charles G
CG
Forsgren
Marianne
M
Krantz
Elizabeth M
EM
Arvin
Ann M
AM
Yasukawa
Linda L
LL
Mohan
Kathleen
K
Brown
Zane
Z
Corey
Lawrence
L
Wald
Anna
A
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006561:Herpes Simplex / Q000097:blood / Q000151:congenital / Q000635:transmission* / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D018258:Herpesvirus 2, Human / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000821:virology*; D012720:Severity of Illness Index; D013548:Sweden; D014481:United States
D000914:Antibodies, Viral