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Herpes simplex - genital - Management
Basis for recommendation
These recommendations are based on the British Association for Sexual Health and HIV (BASHH) 2007 national guideline for the management of genital herpes [BASHH, 2007], a guide for GPs, practice nurses, and other members of the primary care team published by the Medical Foundation for AIDS & Sexual Health (MedFASH) [Madge et al, 2005], and expert opinion in narrative reviews [Sen and Barton, 2007].
- Aciclovir, valaciclovir, and famciclovir are licensed for the treatment of genital herpes in people with HIV [BNF 55, 2008]. CKS could not identify any controlled trials of antivirals for the first episode of genital herpes in people with HIV. However, there is evidence for episodic treatment of recurrent genital herpes in people with HIV. BASHH states that any one of the three antiviral drugs can be used to treat genital herpes in people with HIV. However, CKS recommends that oral aciclovir should be prescribed based on the cost implications. The cost for a 10-day course of aciclovir is £6.12, valaciclovir is £82.19, and famciclovir is £148.45 [Prescription Pricing Division, 2010].
- Self-care advice is based primarily on expert opinion [New Zealand Herpes Foundation, 2007; Sen and Barton, 2007], pragmatism, and good clinical practice. CKS could not identify any controlled trials to support self-care measures in the management of primary genital herpes.
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