OBJECTIVE: During the 2 decades in which effective antiviral therapies have been available for @entity12949 , changes have been documented not only in the outcomes of infected @entity1 , but also in the natural history of the disease itself. Numerous studies previously have reported that early institution of antiviral therapy is beneficial to the outcome of the disease. The objective of this study was to provide an update of neonatal @entity1800 to identify means by which future improvements in the management of HSV-infected neonates can be made. DESIGN/METHODS: Neonates enrolled in 2 studies of parenteral @entity1033 for the treatment of neonatal @entity1800 provided the data source. The National Institute of @entity566 and @entity166 Collaborative Antiviral Study Group conducted the studies between 1981 and 1997. A total of 186 @entity1 are summarized, all of whom were treated with @entity1033 . Demographic and clinical characteristics of these @entity1 are reported. RESULTS: Comparisons between @entity1 treated in the periods between 1981-1988 and 1989-1997 according to extent of disease revealed that the mean time between the onset of disease symptoms and initiation of therapy has not changed significantly from the early 1980s to the late 1990s. Of all @entity1 evaluated, 40% had fetal scalp monitors during the delivery process. A significant minority of @entity1 did not have skin vesicles at the time of their presentation and did not develop them during the @entity697 (39% of @entity1 with disseminated disease; 32% of @entity1 with central nervous system [CNS] disease; and 17% of @entity1 with @entity272 ). Among @entity1 with @entity6220 , mortality was associated with prematurity. Among @entity1 with disseminated @entity1800 treated with @entity1033 at 30 mg/kg/d, mortality was associated with @entity492 transaminase elevations of >/=10 times the upper limit of normal at the time of initiation of @entity1033 therapy. Mortality was also associated with lethargy at initiation of antiviral therapy for @entity1 with disseminated disease. @entity1 ' morbidity status was associated with the extent of disease ( @entity272 vs CNS vs disseminated). For those @entity1 with @entity6220 , morbidity was also associated with @entity410 at initiation of antiviral therapy. CONCLUSION: Data presented in the current @entity12949 over the 2 periods (1981-1988 vs 1989-1997) demonstrate that no progress has been made in decreasing the interval between onset of HSV symptoms and initiation of antiviral therapy. Additional strides in the improvement of disease outcome may occur only if the interval between onset of symptoms and initiation of therapy is shortened. The means by which this will be accomplished lie in increased consideration of neonatal @entity2025 in acutely ill @entity1 . Specific data and recommendations to facilitate this goal are contained within.

Natural history of XXXX in the @entity1033 era.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'infants'] @entity1033 :: ('MESH:D000212', 'Chemical') :: ['acyclovir'] @entity12949 :: ('MESH:C536395', 'Disease') :: ['neonatal herpes simplex virus (HSV) disease', 'comparison of neonatal HSV disease'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute HSV disease'] @entity6220 :: ('MESH:D020279', 'Disease') :: ['CNS disease'] @entity410 :: ('MESH:D012640', 'Disease') :: ['seizures'] @entity566 :: ('MESH:D006967', 'Disease') :: ['Allergy'] @entity2025 :: ('MESH:D020031', 'Disease') :: ['HSV infections'] @entity1800 :: ('MESH:D014777', 'Disease') :: ['HSV disease'] @entity492 :: ('CHEBI:29995', 'Chemical') :: ['aspartate'] @entity272 :: ('MESH:D012871', 'Disease') :: ['skin, eye, and/or mouth disease'] @entity166 :: ('MESH:D003141', 'Disease') :: ['Infectious Diseases']
@entity12949 :: (MESH:C536395,Disease) :: ['neonatal herpes simplex virus infections']
