Module 9 Part 2 Herpes Simplex Virus – Adult Genital Herpes

Question 1

What are the first-line treatments for the first symptomatic episode of Herpes Simplex Type 1 or 2 in adults?

Answer 1

Acyclovir (400 mg TID for 5-7 days), Famciclovir (250 mg TID for 5-7 days), Valacyclovir (500-1000 mg BID for 5-7 days).

Question 2

What are the first-line treatments for acute recurrent episodes of genital herpes in adults (up to 6 episodes per year)?

Answer 2

Acyclovir (400 mg TID for 5 days, or 800 mg BID for 5 days, or 800 mg TID for 2 days), Famciclovir (125 mg BID for 5 days), Valacyclovir (500 mg BID for 3 days or 1000 mg daily for 3 days).

Question 3

What is the first-line treatment for chronic suppressive therapy of genital herpes in non-pregnant adults experiencing more than 6 episodes per year?

Answer 3

Acyclovir (400 mg BID), Famciclovir (250 mg BID), Valacyclovir (250 mg BID, or 500 mg daily; for > 9 episodes per year, use 1000 mg daily).

Question 4

When should treatment for a first symptomatic episode of genital herpes be initiated for maximum benefit?

Answer 4

Treatment should be initiated within 72 hours of symptom onset.

Question 5

What should be done in cases of primary herpes outbreaks during the first trimester of pregnancy?

Answer 5

Treatment is recommended, and if the outbreak is late in the third trimester, consider cesarean delivery due to the higher risk of perinatal transmission.

Question 6

Do topical antivirals have a role in the treatment of genital herpes?

Answer 6

No, they have no role in treatment; analgesics may be required.