Treatment of Herpes Simplex Esophagitis with Impaired Immunity

HSV esophagitis occurring in patients with impaired immunity is a clinically distinct presentation that requires a management approach specifically adapted to the underlying immune status.

Clinical Scenario

This protocol addresses herpes simplex esophagitis in the context of impaired immunity. Immune compromise affects both the course of infection and the duration of treatment needed for adequate response — standard immunocompetent regimens are insufficient in this population.

Treatment approach: Oral antiviral therapy is the basis of treatment in this setting. Because of impaired immunity, the treatment course is extended compared with that used in immunocompetent patients — the complete protocol with all options is available via the link below.

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References

DOI: 10.5114/pg.2013.39914

Patients with impaired immunity should be treated longer with a course of oral acyclovir therapy 400 mg five times a day for 2 to 3 weeks.

Alternatively famiciclovir 500 mg three times a day or valacyclovir 1 g three times a day can be used.

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