6.1.5.2 CDC Treatment of initial Clinical Episodes

HSV Infections

1.5 Treatment

1.5.2 Recommended Treatment of initial Clinical Episodes

Genital Herpes

Therapy shortens the course of illness by up to 7 days. Dramatic effects especially if medication is taken within 7 days of onset of illness and there is no history of oral HSV. The duration of pain and viral shedding is shortened, and the crusting of lesions occurs more quickly.

Acyclovir	400 mg orally 3 times a day for 7 to 10 days
or
Acyclovir	200 mg orally 5 times a day for 7 to 10 days
or
Famciclovir	250 mg orally 3 times a day x 7 to 10 days
or
Valacyclovir	1 g orally 2 times a day x 7 to 10 days

Treatment may be extended if healing is incomplete after 10 days of therapy. Dosage should be increased to 400 mg 5 times a day in HIV infected patients (see subsection 1.7, for the management of HSV in HIV infected Persons)

Rectal Herpes or Stomatitis/Pharyngitis

Consider using higher doses of medication than for genital herpes. Higher doses used in treatment studies, but it is unclear if required.

Acyclovir

400 mg orally 5 times daily for 7 to 10 days

Clinical experience is lacking for effectiveness of famciclovir and valacyclovir in treating proctitis or stomatitis, but they are likely to be effective.