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GENITAL HERPES – MANAGEMENT

At present, no cure is available. Treatment is largely symptomatic and consists of sedatives and analgaesics. Acyclovir (Zovirax), an antiviral agent, can shorten the clinical course of the primary lesion and may benefit patients with frequent severe recurrences. Indications for acyclovir are:
treatment of moderate or severe first episodes of genital herpes (200 mg 5 times daily — each 4 hours while awake — for 10 days);
suppressive treatment for patients with moderate to severe recurrent genital herpes (more than 10 attacks per year with microbiological confirmation) (200 mg 2 to 4 times per day);
treatment of acute lesions in immunosuppressed patients (5 mg/kg by slow IV infusion every 8 hours for 5 days);

suppressive treatment an in immunosuppressed patient with recurrent HSV;
treatment of neonatal infection; and
treatment of ophthalmic infections where idoxuridine proved ineffective (ophthalmic ointment).
Because genital herpes is recurrent and untreatable, patients with HSV are likely to be depressed. Patients and their partners can be assisted by counselling and support. Sexual abstinence should be practised while lesions are active. Patients can be taught to recognise the prodrome and minor symptoms which may indicate recurrence of infectivity. Condoms offer some protection.
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