00:01
So turning now to the treatment of herpes simplex infections,
let’s talk about how you treat the first clinical episode.
00:11
And the duration of that therapy is 7 to 10 days,
and you can use either acyclovir, valacyclovir, or famciclovir.
00:23
These agents work by being chain terminators.
00:28
So as the herpes virus is trying to make more DNA,
these are false basis so the chain of DNA is broken.
00:39
If you're talking about recurrent episodes,
the duration of treatment is variable,
but you use the same agents for 2 to 5 days, 3 to 5 days, or 1 to 5 days.
00:55
Now, how do you manage recurrences?
First of all, you have to define what’s frequent.
01:02
And if a patient has, for example, one or two episodes a year,
then it’s probably prudent to treat those individual episodes
and not use any kind of suppressive therapy.
01:17
So if you have a professional person
who’s job is interfered by the number of recurrences,
you might consider suppressive therapy,
and you do that with acyclovir orally twice a day,
and the efficacy has been established for 6 years,
or you could use valacyclovir.
01:44
Now, the difference between valacyclovir and acyclovir is,
valacyclovir is the valine ester of acyclovir.
01:53
In other words, when you take that medication, it is better absorbed.
01:57
Once in the system, it becomes acyclovir.
02:01
So it’s got better bioavailability,
and as you can imagine, it’s much more expensive.
02:09
Or you could use 1 gram of valacyclovir once a day, famciclovir – twice a day.
02:17
Now what about counseling people with genital herpes?
Well, their sex partners should certainly be informed that they have had herpes.
02:31
Because of asymptomatic shedding of the virus,
you could infect the person when you, yourself, were not symptomatic
and you can actually give a person herpes simplex genitalis
during asymptomatic periods.
02:49
Certainly and obviously,
persons with genital herpes should remain abstinent
when any lesions or any prodromal symptoms are still present.
03:01
And that concludes my discussion of herpes simplex genitalis.