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Herpes simplex - genital - Management
Basis for recommendation
CKS identified no national referral guidelines for genital herpes. In the absence of established policy, these recommendations are based on pragmatism, and good clinical practice.
- The British Association for Sexual Health and HIV (BASHH) 2007 national guideline for the management of genital herpes [BASHH, 2007] suggests that in people who are having breakthrough episodes whilst on suppressive antiviral medication, the daily dose of medication may be increased to control symptoms and reduce further attacks. However, the guideline is unclear about for how long the increased dose should be continued, what follow up is required, and when referral to a specialist is appropriate. Due to the lack of clarity in the guideline, CKS recommends that a primary healthcare professional should seek specialist advice if necessary, based on their own clinical experience, when a person on suppressive treatment presents with breakthrough episodes.
- There is evidence from a randomized controlled trial that suppressive treatment reduces the rate of asymptomatic shedding of herpes simplex virus and, consequently, reduces transmission of the virus [Corey et al, 2004].
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