Journal List > Korean J Urogenit Tract Infect Inflamm > v.9(2) > 1059953

Korean J Urogenit Tract Infect Inflamm. 2014 Oct;9(2):68-73. Korean.
Published online October 31, 2014.  https://doi.org/10.14777/kjutii.2014.9.2.68
Copyright © 2014, Korean Association of Urogenital Tract Infection and Inflammation. All rights reserved.
Recommended Managements for the Herpes Genitalia
Heung Jae Park
Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence to: Heung Jae Park. Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul 110-746, Korea. Tel: +82-2-2001-2237, Fax: +82-2-2001-2247, Email: tigerhj@dreamwiz.com
Received February 19, 2014; Revised March 03, 2014; Accepted March 03, 2014.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Herpes simplex virus (HSV) is a member of herpesviridae family viruses, which belong to DNA viruses. HSV-associated diseases are one of the most widespread infection and most genital herpes is caused by HSV type 2 (HSV-2). Treatment of genital herpes is complex. In addition to administration of the standard antiviral medications, an ideal management protocol should also address various aspects of the disease. Oral acyclovir, valacyclovir, and famciclovir are recommended for routine treatment. Long-term suppressive therapy is effective in reducing recurrence rate as well as the risk of transmission to others. However, antiviral drugs cannot cure HSV infection and persist during the lifetime of the host, often in latent form. Management of the sex partner, appropriate counseling, and prevention advice or education are equally important in management of genital herpes. This review provides a summary of several important recent guidelines regarding recommended management for the herpes genitalia.

Keywords: Herpes genitalis; Antiviral agents; Therapy

Tables


Table 1
Recommended treatment of initial genital herpes in Korean guidelines11
Click for larger image


Table 2
Recommended treatment of recurrent genital herpes in European and Centers for Disease Control and Prevention (CDC) guidelines4, 5
Click for larger image


Table 3
Recommended treatment of recurrent genital herpes in Korean guidelines11
Click for larger image


Table 4
Recommended suppressive treatment of recurrent genital herpes in Korean guidelines11
Click for larger image


Table 5
CDC recommended episodic and suppressive treatment of genital herpes in persons with HIV6
Click for larger image

References
1. Fatahzadeh M, Schwartz RA. Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. J Am Acad Dermatol 2007;57:737–763.
2. Xu F, Sternberg MR, Kottiri BJ, McQuillan GM, Lee FK, Nahmias AJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA 2006;296:964–973.
3. Lee CB, Choe HS, Hwang SJ, Lee SJ, Cho YH. Epidemiological characteristics of genital herpes and condyloma acuminata in patients presenting to urologic and gynecologic clinics in Korea. J Infect Chemother 2011;17:351–357.
4. Katz AR, Lee MV, Wasserman GM. Sexually transmitted disease (STD) update: a review of the CDC 2010 STD treatment guidelines and epidemiologic trends of common STDs in Hawai'i. Hawaii J Med Public Health 2012;71:68–73.
5. Patel R, Alderson S, Geretti A, Nilsen A, Foley E, Lautenschlager S, et al. IUSTI/WHO Europe. European guideline for the management of genital herpes, 2010. Int J STD AIDS 2011;22:1–10.
6. Workowski KA, Berman SM. Centers for Disease Control and Prevention. Sexually transmitted disease treatment guidelines, 2010. MMWR Recomm Rep 2010;59:1–110.
7. Corey L, Benedetti J, Critchlow C, Mertz G, Douglas J, Fife K, et al. Treatment of primary first-episode genital herpes simplex virus infections with acyclovir: results of topical, intravenous and oral therapy. J Antimicrob Chemother 1983;12 Suppl B:79–88.
8. Fife KH, Barbarash RA, Rudolph T, Degregorio B, Roth R. The Valaciclovir International Herpes Simplex Virus Study Group. Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection. Results of an international, multicenter, double-blind, randomized clinical trial. Sex Transm Dis 1997;24:481–486.
9. Reyes M, Shaik NS, Graber JM, Nisenbaum R, Wetherall NT, Fukuda K, et al. Task Force on Herpes Simplex Virus Resistance. Acyclovir-resistant genital herpes among persons attending sexually transmitted disease and human immunodeficiency virus clinics. Arch Intern Med 2003;163:76–80.
10. Martin JM, Villalon G, Jorda E. Update on the treatment of genital herpes. Actas Dermosifiliogr 2009;100:22–32.
11. Korea Centers for Disease Control and Prevention. Korean Association of Urogenital Tract Infection and Inflammation. Sexually transmitted infections Korean guidelines. Seoul: Korea Centers for Disease Control and Prevention, Korean Association of Urogenital Tract Infection and Inflammation; 2011.
12. Weightman W, Turner T. Allergic contact dermatitis from lignocaine: report of 29 cases and review of the literature. Contact Dermatitis 1998;39:265–266.
13. Nilsen AE, Aasen T, Halsos AM, Kinge BR, Tjotta EA, Wikstrom K, et al. Efficacy of oral acyclovir in the treatment of initial and recurrent genital herpes. Lancet 1982;2:571–573.
14. Sacks SL, Aoki FY, Diaz-Mitoma F, Sellors J, Shafran SD. Canadian Famciclovir Study Group. Patient-initiated, twice-daily oral famciclovir for early recurrent genital herpes. A randomized, double-blind multicenter trial. JAMA 1996;276:44–49.
15. Spruance SL, Tyring SK, DeGregorio B, Miller C, Beutner K. Valaciclovir HSV Study Group. A large-scale, placebo-controlled, dose-ranging trial of peroral valaciclovir for episodic treatment of recurrent herpes genitalis. Arch Intern Med 1996;156:1729–1735.
16. Spruance SL, Overall JC Jr, Kern ER, Krueger GG, Pliam V, Miller W. The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. N Engl J Med 1977;297:69–75.
17. Mertz GJ, Loveless MO, Levin MJ, Kraus SJ, Fowler SL, Goade D, et al. Collaborative Famciclovir Genital Herpes Research Group. Oral famciclovir for suppression of recurrent genital herpes simplex virus infection in women. A multicenter, double-blind, placebo-controlled trial. Arch Intern Med 1997;157:343–349.
18. Diaz-Mitoma F, Sibbald RG, Shafran SD, Boon R, Saltzman RL. Collaborative Famciclovir Genital Herpes Research Group. Oral famciclovir for the suppression of recurrent genital herpes: a randomized controlled trial. JAMA 1998;280:887–892.
19. Reitano M, Tyring S, Lang W, Thoming C, Worm AM, Borelli S, et al. International Valaciclovir HSV Study Group. Valaciclovir for the suppression of recurrent genital herpes simplex virus infection: a large-scale dose range-finding study. J Infect Dis 1998;178:603–610.
20. Romanowski B, Marina RB, Roberts JN. Valtrex HS230017 Study Group. Patients' preference of valacyclovir once-daily suppressive therapy versus twice-daily episodic therapy for recurrent genital herpes: a randomized study. Sex Transm Dis 2003;30:226–231.
21. Goldberg LH, Kaufman R, Kurtz TO, Conant MA, Eron LJ, Batenhorst RL, et al. Acyclovir Study Group. Long-term suppression of recurrent genital herpes with acyclovir. A 5-year benchmark. Arch Dermatol 1993;129:582–587.
22. Fife KH, Crumpacker CS, Mertz GJ, Hill EL, Boone GS. Acyclovir Study Group. Recurrence and resistance patterns of herpes simplex virus following cessation of > or = 6 years of chronic suppression with acyclovir. J Infect Dis 1994;169:1338–1341.
23. Mindel A, Faherty A, Carney O, Patou G, Freris M, Williams P. Dosage and safety of long-term suppressive acyclovir therapy for recurrent genital herpes. Lancet 1988;1:926–928.
24. Lebrun-Vignes B, Bouzamondo A, Dupuy A, Guillaume JC, Lechat P, Chosidow O. A meta-analysis to assess the efficacy of oral antiviral treatment to prevent genital herpes outbreaks. J Am Acad Dermatol 2007;57:238–246.
25. Geretti AM. Genital herpes. Sex Transm Infect 2006;82 Suppl 4:iv31–iv34.
26. Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, et al. Valacyclovir HSV Transmission Study Group. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med 2004;350:11–20.
27. Erard V, Wald A, Corey L, Leisenring WM, Boeckh M. Use of long-term suppressive acyclovir after hematopoietic stem-cell transplantation: impact on herpes simplex virus (HSV) disease and drug-resistant HSV disease. J Infect Dis 2007;196:266–270.
28. Kaliaperumal K. Recent advances in management of genital ulcer disease and anogenital warts. Dermatol Ther 2008;21:196–204.
29. Bernstein DI, Aoki FY, Tyring SK, Stanberry LR, St-Pierre C, Shafran SD, et al. GlaxoSmithKline Herpes Vaccine Study Group. Safety and immunogenicity of glycoprotein D-adjuvant genital herpes vaccine. Clin Infect Dis 2005;40:1271–1281.
30. Rajcani J, Durmanova V. Developments in herpes simplex virus vaccines: old problems and new challenges. Folia Microbiol (Praha) 2006;51:67–85.