Prevention of Herpes Simplex Viruses Infection
Prevention
On the whole, preventive measures against HSV infection have been disappointing. The virus is ubiquitous and little or nothing can be done to prevent the transmission of infection in environmental terms. HNIG has not been effective in the prevention of HSV infections. Prophylactic chemotherapy may be given to those suffering from frequent and severe recurrent herpes but the cost factor must be taken into account. In clinical trials, a -interferon eye drops have proved effective for the prevention of recurrent dendritic ulcers.
The only area where there has been some success is the prevention of transmission of infection to newborn babies by the use of caesarean section. The actual decision of whether to carry out a caesarean section or not is very difficult as maternal genital herpes is common whereas neonatal herpes is rare. Furthermore, asymptomatic shedding of HSV is common. Generally, caesarean sections are not carried out for cases of recurrent herpes (except where florrid lesions are present and with the mother’s informed consent) but for cases where there is florid primary infection. The neonate should be closely monitored and acyclovir should be given on the merest suspicion of genital herpes. If the mother develops primary HSV infection during the first or second trimester of pregnancy, antiviral therapy may be considered. If the mother contracts primary herpes during weeks 30-34 of pregnancy, she may be treated by a acyclovir followed by Casarean section or normal delivery. The mother with primary genital herpes between week 34 and term should be delivered by Caesarean section. A woman who presents with primary genital herpes while in labour may be treated with IV acyclovir, although it is uncertain whether this will reduce the rate of transmission.
HSV_vaccines - Several
recombinant subunit vaccines are being evaluated at present.
There is evidence to suggest that such vaccines may be effective
in reducing the frequency and severity of recurrent disease in an
already immune individual, but their efficacy in preventing
primary infection is uncertain. Primary infection per se is not a
condition worth preventing except in immunosuppressed patients.
However, such vaccines may be useful in preventing or attenuating
recurrent disease.
