Treatment of Recurrent Genital Herpes When Not Pregnant and Not Living With HIV

This protocol covers the management of recurrent genital herpes episodes in adults who are not pregnant and are not living with HIV — a common outpatient scenario where prompt, patient-initiated treatment shapes outcomes.

Clinical scenario

Recurrent genital herpes in an adult who is not pregnant and not living with HIV. The focus is on episodic treatment of individual outbreaks rather than continuous suppressive therapy.

Treatment approach

Management is built around episodic short-course oral antiviral therapy, initiated as early as possible after symptom onset. Both short-course and longer alternative regimens exist; the full protocol specifies which options apply and under what circumstances.

Specific agents, regimens, and sequencing are detailed in the structured protocol below.

Clinical goal

Successful treatment reduces the duration of the recurrence by a median of 1–2 days.

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References

DOI: 10.1111/jdv.20450

Oral aciclovir, valaciclovir and famciclovir are effective at reducing the duration and severity of recurrent genital herpes.
Patient-initiated treatment started within 24 h is most likely to be effective.
The reduction in duration is a median of 1–2 days (1, A).

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