genital%20herpes
GENITAL HERPES
Genital herpes is a recurrent lifelong disease with no cure, caused by herpes simplex virus (HSV).
HSV-2 is usually the cause but HSV-1 may occur in up to 1/3 of new cases.
HSV-1 tends to cause fewer recurrences & milder disease than HSV-2.
The incubation period is 2 days-2 weeks after exposure.

Pharmacotherapy

  • Use is warranted in suspected or diagnosed initial genital herpes infection with lesions not yet fully crusted
    • To be administered within 5 days of the start of infection and continued until new lesions are forming or if there is persistence of systemic symptoms
    • Treatment within 1 day of lesion onset may end development of lesions
  • Antivirals are effective in reducing severity and duration of symptoms
    • Neither can eliminate the virus nor affect the risk and natural course of genital herpes infection
  • Oral antivirals are more effective than topical agents in the management of the initial episode
  • Choice of agent depends on cost, dosing schedule and patient preference
    • Oral Aciclovir, Famciclovir, and Valaciclovir have similar efficacy

Aciclovir (Oral, IV)

  • Acyclic purine nucleoside analogue that is a competitive inhibitor of viral DNA polymerase
  • Limits viral replication and stops further spread of the virus to other cells
  • Oral and IV are both effective in treating HSV-1 and HSV-2
  • IV is usually reserved for severe disease or complications where hospitalization is necessary
  • Topical agent has limited efficacy, hence not recommended
  • Bioavailability is poor requiring frequent dosing

Famciclovir (Oral)

  • Famciclovir is a pro-drug of Penciclovir
  • Has higher bioavailability than Penciclovir and is rapidly converted to Penciclovir in GIT, blood and liver
  • Penciclovir has similar mechanism of action as Aciclovir

Valaciclovir (Oral)

  • L-valine ester pro-drug of Aciclovir, rapidly metabolized to Aciclovir by liver and intestine
  • Has better absorption after oral administration than Aciclovir making lower doses or lesser dosing frequency possible
  • Has been shown to decrease risk of transmission
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
4 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Roshini Claire Anthony, 6 days ago

Women who receive a single dose of amoxicillin and clavulanic acid within 6 hours of operative vaginal delivery could significantly reduce their postpartum infection risk, according to the UK-based ANODE* trial.

Pearl Toh, Yesterday
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
4 days ago
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.