Treatment of perinatal viral infections to improve neurologic outcomes

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Viral infections in the fetus or newborn often involve the central nervous system (CNS) and can lead to significant morbidity and mortality. Substantial progress has been made in identifying interventions decreasing adverse neurodevelopmental outcomes in this population. This review highlights progress in treatment of important viruses affecting the CNS in these susceptible hosts, focusing on herpes simplex virus (HSV), cytomegalovirus (CMV), human immunodeficiency virus (HIV), and enteroviruses. The observation that high-dose acyclovir improves mortality in neonatal HSV disease culminated decades of antiviral research for this disease. More recently, prolonged oral acyclovir was found to improve neurologic morbidity after neonatal HSV encephalitis. Ganciclovir, and more recently its oral prodrug valganciclovir, is effective in improving hearing and neurodevelopment after congenital CMV infection. Increasing evidence suggests early control of perinatal HIV infection has implications for neurocognitive functioning into school age. Lastly, the antiviral pleconaril has been studied for nearly two decades for treating severe enteroviral infections, with newer data supporting a role for this drug in neonates. Identifying common mechanisms for pathogenesis of viral CNS disease during this critical period of brain development is an important research goal, highlighted by the recent emergence of Zika virus as a potential cause of fetal neurodevelopmental abnormalities.

Original languageEnglish (US)
Pages (from-to)162-169
Number of pages8
JournalPediatric Research
Volume81
Issue number1-2
DOIs
StatePublished - Jan 1 2017

Fingerprint

Virus Diseases
Simplexvirus
Nervous System
Acyclovir
Antiviral Agents
Central Nervous System Viral Diseases
Central Nervous System
HIV
Herpes Simplex Encephalitis
Morbidity
Ganciclovir
Mortality
Enterovirus
Prodrugs
Cytomegalovirus Infections
Cytomegalovirus
Research
Hearing
Fetus
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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Treatment of perinatal viral infections to improve neurologic outcomes. / Muller, William J.

In: Pediatric Research, Vol. 81, No. 1-2, 01.01.2017, p. 162-169.

Research output: Contribution to journalReview article

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