Herpes

Transmission
  • Physical contact. Active lesions increase risk of transmission.
Symptoms
  • Painful vesicular rash and ulcers on penis, scrotum, and/or around the anus.
Testing
  • Swab active lesions and send in viral transport media for either culture or nucleic acid amplification (NAAT).
Treatment
  • First outbreak:
    • Acyclovir 200mg PO 5 times a day for 5-10 days
    • Famciclovir 250mg PO TID for 5 days
  • Valacyclovir 1000mg PO BID for 10 days
  • Recurrent outbreak:
    • Acyclovir 800 mg TID for 2 days
    • Famciclovir 125 mg BID for 5 days
    • Valacyclovir 1000 mg daily for 3 days
  • Suppressive therapy:
    • Acyclovir 400 mg BID
    • Famciclovir 250 mg BID
    • Valacyclovir 500 mg daily if <9 recurrences per year / 1000 mg daily if >9 recurrences per year