Prevention and Management of Genital Herpes

Abstract and Introduction

Abstract

Genital herpes continues to be a relevant public-health concern because of its prevalence and its association with an increased risk of acquiring other sexually transmitted diseases. Genital herpes may present as vesicular lesions that can rupture and become painful; however, more than 80% of individuals are asymptomatic, which makes it difficult to contain the spread of disease. The treatment of genital herpes serves to shorten symptom duration and improve quality of life, but it does not cure the disease. Strategies to prevent transmission include chronic suppressive therapy in serodiscordant couples, safe-sex practices, and avoidance of sexual intercourse during outbreaks. Currently available therapies are well tolerated and highly effective, and some newer therapeutic options are being investigated.

Introduction

Genital herpes is a major public- health concern because of its recurrent nature, its ability to be transmitted asymptomatically, and its potential for complications.^[1] This sexually transmitted disease (STD) is caused by herpes simplex virus types 1 and 2 (HSV-1 and HSV- 2), in most cases by HSV-2.^[2] Genital herpes is the most common cause of genital ulceration in the United States; more than 50 million Americans are infected, and an estimated 776,000 new cases occur each year.^[1,3] Nationally, 15.5% of persons aged 14 to 49 years are infected with HSV-2, and the prevalence of genital herpes may be higher owing to increasing rates of HSV-1 causation.^[4] Genital herpes is also a significant public-health concern for the global community, with more than 500 million people infected worldwide.^[5] These estimates likely are low; many cases of genital herpes are unreported since people often are unaware that they have been infected.

Demographically, HSV-2 infection is more common in women than in men, and in the non-Hispanic black population, there is an increased prevalence in both sexes. Even among persons with similar numbers of lifetime sexual partners, this disparity between the ethnicities remains.^[3] Most people with symptomatic genital herpes will experience recurrent infections within the first year of the primary infection, and the median recurrence rate is four to six episodes per year.^[6]

Table 1. CDC Dosing Recommendations for Initial Episode
Generic Name	Brand Name	Route of Administration	Usual Adult Dosing
Acyclovir	Zovirax	Oral	400 mg tid for 7–10 days or 250 mg 5 times daily for 7–10 days
Famciclovir	Famvir	Oral	250 mg tid for 7–10 days
Valacyclovir	Valtrex	Oral	1 g bid for 7–10 days

Source: Reference 11.

Table 2. CDC Dosing Recommendations for Recurrent Episodes
Generic Name	Brand Name	Route of Administration	Usual Adult Dosing
Acyclovir	Zovirax	Oral	400 mg tid for 5 days, or 800 mg bid for 5 days, or 800 mg tid for 2 days
Famciclovir	Famvir	Oral	125 mg bid for 5 days, or 1 g bid for 1 day, or 500 mg once followed by 250 mg bid for 2 days
Valacyclovir	Valtrex	Oral	500 mg bid for 3 days or 1 g once daily for 5 days

Source: Reference 11

Table 3. CDC Dosing Recommendations for Suppressive Therapy
Generic Name	Brand Name	Route of Administration	Usual Adult Dosing
Acyclovir	Zovirax	Oral	400 mg bid
Famciclovir	Famvir	Oral	250 mg bid
Valacyclovir	Valtrex	Oral	500 mg-1 g once daily

Source: Reference 11.

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Prevention and Management of Genital Herpes

Abstract and Introduction

Abstract

Introduction

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

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