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Section 6  Herpes Simplex Virus (HSV) Infections
Section 6 Objectives
6.1.0  Biology of Genital Herpes
6.1.1  Pathogenesis of Disease
6.1.2  Epidemiology of Genital Herpes Infections
6.1.3  Clinical Manifestations of Genital Herpes
1.4  Laboratory Diagnosis
6.1.5.0 Treatment, Available Medications
6.1.5.0 Treatment, Available Medications
6.1.5.1 Treatment Regimens
6.1.5.2 Initial Clinical Episodes
6.1.5.3 Recurrences
6.1.5.4 Episodic Treatment of  Recurrent Infections
6.1.5.5 Suppressive Therapy for Frequent Recurrences
6.1.5.6 Intravenous Treatment
6.1.6  HSV in Pregnancy
6.1.7  Genital Herpes and HIV Infection
6.1.8  Counseling and Sexual Contacts
6.1.9  Prevention of HSV
6.1.10 Interactive web-based case
6.2.0  Review Questions
6.2.1 CME Credit Questions
6.2.2  References
1.0  Pathophysiology and Definition

 

 

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HSV Infections

1.5 Treatment

1.5.2 Centers for Disease Control Homepage 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.

 

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