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Persistence of herpes simplex virus DNA in cerebrospinal fluid of neonates with herpes simplex virus encephalitis

Journal of Perinatology volume 29, pages 290–296 (2009)Cite this article

Abstract

Objective:

The significance of detecting herpes simplex virus (HSV) DNA in the cerebrospinal fluid (CSF) of infants with HSV encephalitis after receipt of prolonged therapy with high-dose (60 mg kg−1 day−1) acyclovir is unknown. We report the clinical and laboratory characteristics, neuroimaging studies and outcomes of four neonates with HSV encephalitis who had persistence of CSF HSV DNA, by polymerase chain reaction (PCR) after 15 to 21 days of high-dose acyclovir therapy.

Study Design:

Retrospective chart review.

Results:

All four infants had abnormal neuroimaging studies and subsequently experienced severe developmental delay or death.

Conclusion:

A persistently positive CSF HSV PCR in neonates may be another risk factor for worse neurodevelopmental outcome. Prospective studies are needed to document how often HSV DNA persists in CSF, elucidate whether it represents an initially high CSF viral load, ongoing viral replication or viral resistance, and determine its possible association with neurodevelopmental impairment.

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Abbreviations

HSV:

Herpes simplex virus

CSF:

Cerebrospinal fluid

CNS:

Central nervous system

PCR:

Polymerase chain reaction

MRI:

Magnetic resonance imaging

CT:

Computed tomography

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Authors and Affiliations

  1. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX

    A Mejías, M I Ardura, C Ramírez & P J Sánchez

  2. Department of Pediatrics, University of Concepción, Chile

    R Bustos

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  1. A Mejías
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  2. R Bustos
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  3. M I Ardura
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  4. C Ramírez
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  5. P J Sánchez
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Correspondence to A Mejías.

Additional information

This work was presented in part at the Pediatric Academic Societies Meeting, Toronto, Canada from May 5 to 7, 2007.

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Mejías, A., Bustos, R., Ardura, M. et al. Persistence of herpes simplex virus DNA in cerebrospinal fluid of neonates with herpes simplex virus encephalitis. J Perinatol 29, 290–296 (2009). https://doi.org/10.1038/jp.2008.235

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