Herpes simplex virus in kids

For primary mucocutaneous HSV infections, including orolabial and anogenital disease, oral acyclovir, valacyclovir, and famciclovir have all been shown to hasten the resolution of symptoms as well as reduce the duration of viral shedding. Initiating oral therapy at the first sign of recurrent mucocutaneous disease may alleviate symptoms somewhat, but the benefit is less substantial than is seen in primary HSV infections.

Therefore, chronic suppressive therapy should be considered in patients with frequent mucocutaneous recurrences. In the context of recurrent mucocutaneous HSV infections, the decision to treat individual outbreaks episodic therapy or to use suppressive therapy Table 2 is based primarily on the frequency of recurrences and the resultant debility of each patient.

When taken chronically, oral acyclovir, valacyclovir, and famciclovir have all been shown to reduce the frequency of recurrence, the severity of individual episodes, and the degree of viral shedding in adults with recurrent mucocutaneous infections. Suppressive therapy following a completed course of intravenous acyclovir in patients with neonatal HSV infection may have a benefit as well.

Some experts have recommended initiating suppressive therapy with oral acyclovir for neonates with HSV infection after the first mucocutaneous recurrence.

The results are anticipated in the near future. Although acyclovir and the other guanosine derivative nucleoside analogs that are currently licensed to treat HSV infections have significantly improved our capacity to manage these conditions, novel therapeutic approaches are needed to improve I patient outcomes further. Prevention of HSV infection is the primary goal, whether by simply reducing transmission rates or, ideally, by developing a vaccine.

When treating HSV infections of the CNS, a major limitation is the inability of nonlipophilic agents to penetrate adequately into infected brain tissue. Highly lipophilic antiviral agents have the ability to exert their antiviral activity in the affected CNS tissue more rapidly and achieve higher intracellular concentrations at the site of infection. Several other novel HSV therapies are in various stages of evaluation. The helicase-primase complex inhibitors are a promising new class of antiviral agents with potent in vitro activity against HSV.

BAY has been shown to have excellent activity specifically against HSV, and another recently reported helicase-primase inhibitor, ASP, demonstrated greater potency than acyclovir against HSV and varicella zoster virus. HSV infection is a common occurrence in the pediatric population. Although the incidence of life-threatening HSV disease is lower, HSV infection is still associated with substantial morbidity and mortality. Acyclovir and related compounds have significantly improved the efficacy and tolerability of treatment and suppression of HSV infections.

Future directions include the continued development of safe and effective antiviral agents, as well as the development of vaccine candidates for further study. National Center for Biotechnology Information , U. Clin Pharmacol Ther. Author manuscript; available in PMC Jun Author information Copyright and License information Disclaimer.

Correspondence: RJ Whitley ude. Copyright notice. The publisher's final edited version of this article is available at Clin Pharmacol Ther.

See other articles in PMC that cite the published article. Abstract Herpes simplex virus type 1 HSV-1 and type 2 HSV-2 are members of the Herpesviridae family and are characterized by their ability to establish latency after primary infection and subsequently reactivate. Primary and recurrent mucocutaneous infections Primary, or first-episode, HSV infection is usually asymptomatic. Ocular infections Primary or first-episode ocular infections are usually caused by HSV-1 and most commonly present as a blepharoconjunctivitis characterized by follicular conjunctivitis and the presence of vesicles at the margin of the eyelid.

Table 1 Treatment of pediatric HSV infections. Famciclovir a mg p. Recurrent Acyclovir mg p. Famciclovir a 1. In the vast majority of children, cold sores are annoying and painful but don't cause complications or serious consequences. In rare cases, the herpes simplex virus can cause inflammation of the brain encephalitis.

This is a serious illness and needs to be treated right away. It can lead to long-term problems of the brain. Cold sores in a newborn baby can cause serious illness and death.

This may be the case even when treated with medicine. If someone in your household has herpes simplex, you can protect your child by making sure they are not exposed. Keep in mind that the virus may be in saliva even when there are no cold sores. Tell your child not to kiss, share cups or utensils, or share washcloths or towels with the person.

Tell your child not to touch a cold sore. The healthcare provider may advise keeping your child home from school during the first infection of herpes simplex virus. Sun protection can help prevent future cold sore breakouts. Apply a lip balm that contains sunscreen. And have them wear a hat with a brim. It can be spread to others by kissing, sharing cups or utensils, sharing washcloths or towels, or by touching the cold sore before it is healed.

Symptoms include a small blister or group of blisters on the lips and mouth that enlarge, leak fluid, then crust over. In most children, cold sores do not cause complications. Rarely, the herpes simplex virus can cause inflammation of the brain encephalitis. If your child has a cold sore, make sure they don't kiss, share cups or utensils, share washcloths or towels, or touch the cold sore. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests.

Your child may also have tests, such as:. Skin scrapings. The sores are gently scraped to remove tiny samples. The samples are examined to look for the virus. It will also depend on how severe the condition is. Treatment may include antiviral medicine and other types of prescription medicines. These medicines work best if started as soon as possible after the first sign of a herpes infection or recurrence.

Cold sores usually don't scar. They last 10 to 14 days. In most children, cold sores don't cause serious illness. In some cases, the herpes simplex virus can cause inflammation of the brain encephalitis.

This is a serious illness and needs to be treated right away. It can lead to long-term problems of the brain. Two drops are applied to the infected eye five times daily until resolved. Recurrences are managed in a similar manner. Some physicians administer oral acyclovir at the doses noted above in order to prevent frequent recurrences. Genital HSV infections can be treated with acyclovir, valaciclovir, or famciclovir.

Episodic treatment of recurrent episodes is usually not necessary in childhood.