The antiviral drugs acyclovir, valacyclovir, and famciclovir are often prescribed to treat herpes viral infections, such as herpes simplex virus (HSV). More than one in five pregnant women have antibodies in their blood to HSV, indicating a past or present infection. Given the small size of the registry there are no sufficient data to assess the safety of acyclovir in pregnant women and the fetus. Primary herpes simplex infection during pregnancy has been treated with acyclovir, although this practice remains controversial. Background: The antiviral agents acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are commonly used to treat initial and recurrent cases of herpes simplex virus infection, and to lessen the severity of herpes zoster virus infection.
Pregnant women with genital herpes should use antiviral medication throughout pregnancy to decrease the risk of recurrent lesions and transmission to the baby. Women with active herpetic lesions during delivery are at the highest risk of transmitting the infection to the baby, so those women will be encouraged to have a cesarean delivery. Acyclovir, valacyclovir, and famciclovir are all used for long-term suppressive therapy. Question One of my patients is a pregnant woman in her first trimester with a history of recurrent genital herpes. 6 Treatment with antivirals in adults has established their efficacy and safety, but evidence of the safety of acyclovir, famciclovir, and valacyclovir during pregnancy is relatively lacking. This article concentrates on the management issues specific to genital herpes infection during pregnancy. Where a woman has acquired a first genital herpes infection in the first or second trimester, she should then take a suppressive dose of aciclovir 400 mg three times a day from 36 weeks of gestation. Although antivirals are believed to be safe in pregnancy, the risk:benefit balance changes for recurrent infection because episodes are usually shorter and self-limiting.
Some physicians have reported intentional use of acyclovir during pregnancy for treatment of life-threatening herpes simplex infection. Acyclovir is an antiviral medication for treating simplex infections like cold sores, herpes, shingles, and chickenpox. It belongs to the brand Zovirax. Is it safe to use while pregnant and/or breastfeeding? Indications: Herpes simplex or Varicella-Zoster infections. If acyclovir is prescribed for a primary genital herpes infection (the first infection of the virus), it is extremely important that the course of treatment be completed as prescribed and all follow-up visits with the prescribing physician be followed.
Genital Herpes Suppressive Treatment In Pregnancy
If a woman with genital herpes has virus present in the birth canal during delivery, herpes simplex virus (HSV) can be spread to an infant, causing neonatal herpes, a serious and sometimes fatal condition. Babies are most at risk for neonatal herpes if the mother contracts genital herpes late in pregnancy. Many women wonder about taking antiviral medication during pregnancy to suppress outbreaks in the third trimester. Small studies suggest that acyclovir taken daily during the last month of pregnancy will prevent recurrences and, therefore, decrease the need for Cesarean sections, but some experts remain concerned about the safety of fetal exposure to the medication. Initial episode For most people, the first herpes outbreak is the most severe, and symptoms tend to be more severe in women than men. For this reason, preventive antiviral therapy with acyclovir is often recommended for women with one or more recurrences during pregnancy. Some experts recommend taking a break from treatment periodically (every few years) to determine if suppressive therapy is still needed. Once you have been infected with a herpes virus, whether it’s genital herpes or cold sores, it stays in your body for life (RCOG 2014a). Tell your midwife if you or your partner has genital herpes because in some situations, the virus can be harmful to babies (Pinninti 2014). It’s possible that in early pregnancy, you won’t need any drug treatment for your symptoms. The GUM clinic or your obstetrician may offer you a short course of treatment with the antiviral drug, Aciclovir, when your symptoms first appear. Infection with genital herpes simplex virus (HSV) (see the image below) remains a common viral sexually transmitted disease, often subclinical, and a major worldwide problem in women of reproductive age. Pregnant women with untreated genital herpes during the first or second trimester appear to have a greater than two-fold risk of preterm delivery compared with women not exposed to herpes, particularly in relation to premature rupture of membrane and early preterm delivery ( 35 wk of gestation). Acyclovir is one of the oldest drugs used to treat herpes simplex viruses and remains the first line of treatment for these infections. Researchers have not studied acyclovir use by pregnant women, so there’s not enough evidence to say that it is safe to take during pregnancy. Most new cases of genital herpes infection do not cause symptoms, and many people infected with HSV-2 are unaware that they have genital herpes. Tests such as chorionic vilus sampling, amniocentesis, and percutaneous fetal blood draws can safely be performed during pregnancy. Patients who are treated with acyclovir within 2 days of becoming ill have the best chance for a favorable outcome.
Pregnancy Outcomes Following Systemic Prenatal Acyclovir Exposure
Women who have a history of genital herpes often wonder whether or not it is safe for them to deliver their baby naturally. Learn about the consequences of having a genital herpes outbreak during pregnancy. Because of this, antiviral treatment with acyclovir is often recommended for all pregnant women with one or more recurrences sores during pregnancy. Most new cases of genital herpes infection do not cause symptoms, and many people infected with HSV-2 are unaware that they have genital herpes. Babies born to mothers infected with genital herpes are often treated with the antiviral drug acyclovir, which can help suppress the virus. Men who are circumcised should still practice safe sex, including using condoms. Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy. If you’re taking acyclovir for herpes and thinking about getting pregnant, you may be wondering if acyclovir and pregnancy can mix. The highest risk comes when the mother has an active outbreak of genital herpes when the baby is born. Herpes and Pregnancy – Covers transmission, treatments, medications, symptoms, self-help, diet & nutrition, current research and information, products for Herpes Pregnancy, and URL pointers to other sites. I want to tell other mothers that I know it’s hard not to worry when your baby’s safety is at stake. Acyclovir is occasionally prescribed for pregnant women who suffer from extremely frequent outbreaks, or those who acquire genital herpes during pregnancy.