How is herpes simplex virus (HSV) keratitis in HIV infection treated?

Updated: Jun 12, 2019
  • Author: Robert A Copeland, Jr, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Most cases of HSV epithelial keratitis resolve spontaneously within several weeks. The rationale for treatment is to decrease corneal damage due to lytic viral infection and virus-incited immunologic response. Debridement of HSV epithelial keratitis with a dry cotton-tipped applicator or a cellulose sponge can hasten resolution and decrease the load of infectious virus and viral antigens.

Medical treatment includes the use of vidarabine ophthalmic 3% ointment 5 times daily for 14 days and/or trifluridine ophthalmic 1% solution every 3 hours for 14 days; ganciclovir 0.15% ophthalmic gel 5 times daily until the ulcer heals and then 3 times a day for 7 days; or acyclovir topical 3% ointment 5 times daily for 14 days or oral dosage form 400 mg 5 times daily for 7 days; or famciclovir 500 mg by mouth 3 times daily for 7 days.

HSV neurotrophic keratopathy is a condition that should be managed with nonpreserved lubricants, eyelid patching, bandage contact lenses, and sometimes autologous serum and nerve growth factor.

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