Herpes simplex natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Pregnant women who have an active herpes infection on their genitals or in their birth canal when they deliver may pass the infection to their newborn infant. The risk of passing the infection to the baby is highest if the mom first becomes infected with herpes during pregnancy. Babies of women who become infected during pregnancy are at risk for premature birth. The baby may develop brain infection (meningitis, encephalitis) , chronic skin infeciton, severe developmental delays, or death. The risk for severe infection in the baby is lower in recurrent outbreaks, with the highest risk in women experiencing an outbreak at the time of delivery. Women with a history of herpes but who only have occasional or no outbreaks rarely transmit the infection to their babies.

Some people may develop severe herpes infections that involve the brain, eyes, esophagus, liver, spinal cord or lungs. These complications often develop in people who have a weakened immune system, AIDS, are undergoing chemotherapy or radiation therapy, or who take high doses of cortisone. Someone with an active herpes infection who has sexual contact with someone who is HIV positive is more likely to contract HIV infection themselves.

Natural History

Complications

1) Recurrent episodes of painful genital sores

2) Severe infection in people with suppressed immune systems

3) Psychological distress

4) Genital HSV can lead to potentially fatal infections in babies.

  • It is important that women avoid contracting herpes during pregnancy because a newly acquired infection during late pregnancy poses a greater risk of transmission to the baby.
  • If a woman has active genital herpes at delivery, a cesarean delivery is usually performed.
  • Fortunately, infection of a baby from a woman with herpes infection is rare.

5) Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.

6) Infections involving the brain, eyes, esophagus, liver, spinal cord, or lungs often develop in people who have a weakened immune system, AIDS, are undergoing chemotherapy or radiation therapy, or who take high doses of cortisone.

Prognosis

References

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