Use of antiviral drugs in late pregnancy for reducing the recurrence of genital herpes at labor and birth and reducing the risk of newborn HSV infection

The incidence of herpes, a sexually transmitted disease, varies across the world. Among pregnant women with herpes, nearly 75% can expect at least one flare-up during their pregnancy. Transmission of the virus from mother to baby typically occurs by direct contact with the virus during birth. It is often recommended that a cesarean should be offered to women with active lesions to reduce the risk of transmission to the baby. In addition, several antiviral agents are available for use both for therapy and for preventing a flare-up. These antiviral drugs include acyclovir, penciclovir, valacyclovir, and famciclovir. The review assessed whether antiviral drugs given to pregnant women with herpes before a recurrence might be effective in reducing transmission to the baby. Seven studies were identified involving 1249 women. Giving antiviral drugs reduces viral shedding and recurrences at labor and birth. They also reduced the use of cesarean, but there is no evidence of reduction in neonatal herpes. Women should also be informed that the risk of the baby getting herpes during birth is low.