Epidemiology and treatment of herpes simplex virus in the neonatal intensive care unit

Nellie Chen; Ryan Kilpatrick; Erik J VerHage; P Brian Smith; Areej Bukhari; Chi D Hornik; Veeral N Tolia; Daniel K Benjamin Jr; Rachel G Greenberg

doi:10.1038/s41372-024-02150-8

Epidemiology and treatment of herpes simplex virus in the neonatal intensive care unit

J Perinatol. 2024 Oct 11. doi: 10.1038/s41372-024-02150-8. Online ahead of print.

Authors

Nellie Chen¹, Ryan Kilpatrick², Erik J VerHage³, P Brian Smith^{4

5}, Areej Bukhari^{4

6}, Chi D Hornik^{4

5}, Veeral N Tolia⁷, Daniel K Benjamin Jr^{4

5}, Rachel G Greenberg^{8

9}

Affiliations

¹ Duke University School of Medicine, Durham, NC, USA.
² Division of Newborn Medicine, Tufts University School of Medicine, Boston, MA, USA.
³ Department of Pediatrics, University of Florida, Gainesville, FL, USA.
⁴ Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
⁵ Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
⁶ Department of Pediatrics (Infectious Diseases), Atrium Health Levine Children's Hospital and Wake Forest University School of Medicine, Charlotte, NC, USA.
⁷ Pediatrix Center for Research, Quality, Education and Safety, Sunrise, FL, USA.
⁸ Department of Pediatrics, Duke University Medical Center, Durham, NC, USA. [email protected].
⁹ Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA. [email protected].

PMID: 39394454
DOI: 10.1038/s41372-024-02150-8

Abstract

Objective: Describe the epidemiology and clinical characteristics of infants in the neonatal intensive care unit (NICU) with acyclovir exposure and herpes simplex virus (HSV) infection.

Study design: Our primary analysis was to evaluate the prevalence of HSV infection among infants in the NICU who received acyclovir. We compared characteristics of infants with and without HSV and used multivariable regression analyses to assess associations between infection and clinical outcomes.

Result: Of 1,057,061 infants, 17,910 (2%) received acyclovir. Of those who received acyclovir, 1090 (5%) had HSV. Infection was associated with lower gestational age and lower birth weight. Multivariable models demonstrated that infected infants had higher mortality, greater postmenstrual age at discharge, and longer length of stay.

Conclusion: Infants in the NICU who received acyclovir and have HSV are more likely to be born at lower gestational age, have lower birth weight, and have higher morbidities and mortality.