Presented by: David Kimberlin. Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.

Perinatally acquired herpes simplex virus (HSV) and congenitally acquired cytomegalovirus (CMV) infections contribute to significant morbidity and mortality among young infants worldwide. The current estimate of the incidence of neonatal HSV disease in the USA is approximately 1 in 3200 deliveries, while that of congenital CMV infection in the USA and worldwide is approximately 1 in 100 deliveries. Significant advances in the treatment of neonatal HSV which have occurred over the past 30 years, initially with vidarabine and then with aciclovir, have led to improved outcomes among affected neonates. More recent advances in the treatment of congenital CMV with intravenous ganciclovir have raised hopes that similar improvements in neurologic as well as audiologic outcomes may be possible in this disease as well. Ongoing clinical research studies for congenital CMV are focusing on the use of oral valganciclovir rather than intravenous ganciclovir to improve tolerability of therapy, and on evaluating extended durations of antiviral administration to improve responsiveness to therapy. Given the toxicities associated with ganciclovir and valganciclovir, treatment of congenital CMV can only be considered at the current time for neonates and young infants with symptomatic CMV disease.