Suppressive oral acyclovir therapy for 6 months improved neurodevelopmental outcomes in infants with central nervous system involvement.
Neurological sequelae in survivors of neonatal herpes simplex virus (HSV) disease are significant, particularly in infants with central nervous system (CNS) involvement, but occasionally in those with only skin, eye, and mouth (SEM) disease. In two parallel multicenter, randomized, controlled studies, researchers compared neurodevelopmental effects of 6 months of suppressive oral acyclovir (300 mg/m2 body surface area 3 times daily) or placebo following standard initial neonatal HSV therapy in 45 infants with CNS involvement (including 8 with disseminated disease) and in 29 infants with SEM disease.
Infants were seen at 2 and 4 weeks after initiation of treatment and then monthly for 5 months; Bayley Scales of Infant Development testing was …