Genital herpes

Sexually transmitted infection caused by herpes simplex virus (HSV-2 more often, HSV-1 less). Presents as painful vesicles and erosions on the genitals, with fever and regional lymphadenitis during the primary episode. Recurrences are milder. Treatment: oral aciclovir, valaciclovir or famciclovir; suppressive therapy at ≥6 recurrences per year.

ICD-10 A601 drug

Also known as: Herpes simplex genitalis, HSV-2 genital infection

Drugs used for this condition

AFamciclovirFirst line · Antiviral nucleoside analogue for herpes infections (HSV-1, HSV-2, VZV)For genital herpes, famciclovir is used for the primary episode (250 mg three times daily for 5 days) and recurrences (1000 mg twice daily for 1 day or 125 mg twice daily for 5 days). With frequent recurrences (≥6 episodes per year) NICE 2023 recommends suppressive therapy: 250 mg twice daily for 6–12 months, with periodic review. Treatment within 24 hours of recurrence shortens the episode by 1–2 days.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit