What is the role of systemic antivirals in the treatment of genital herpes?

Updated: Mar 17, 2020
  • Author: Sean P McGregor, DO, PharmD; Chief Editor: William D James, MD  more...
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Systemic antivirals may be given for episodic disease recurrence or as long-term suppressive therapy. Episodic treatment can be considered for patients with few recurrences and those who experience a prodrome of symptoms signifying the need for initiation of systemic antivirals. Patients with multiples recurrences (6 or more) per year and those with unaffected partners may benefit from long-term suppressive therapy. Long-term suppressive therapy leads to a 70-80% reduction in the frequency of recurrences and decreases the rate of transmission. [48] Valacyclovir administered as long-term suppressive therapy has been shown to reduce transmission by 48%. [56] Recommendations for the episodic treatment of genital herpes and long-term suppressive therapy in immunocompetent and immunocompromised patients have been developed by the US Centers for Disease Control and Prevention (CDC) and are summarized below. [48]

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