3/11/2024 0 Comments Download the new Zotero 6.0.27With genital lesions, crust formation depends on whether the skin area is dry (3-4 days) or moist (8-9 days). (13,16) Most herpes labialis lesions progress from the vesicle stage to the ulcer/soft crust stage within 48 hours, with a hard crust forming by day 2 or 3 (FIGURE 1B). Herpes labialis lesion size and pain are also greatest in the first 24 hours. (13,14) In both recurrent herpes labialis and genital herpes, HSV viral titers peak in the first 24 hours following lesion onset (FIGURE 1A). The innate and acquired immune responses of chronically infected, immunocompetent persons rapidly limit cutaneous viral replication, thereby truncating the duration of recurrent HSV outbreaks. * Take advantage of a brief therapeutic window (3) If the efficacy of short-course treatment is the same as that of longer courses, the increased convenience and expected improvement in patient adherence with these new regimens argue strongly in their favor. In one head-to-head comparison, Leone et al compared a short-course regimen (3 days) of valacyclovir with 5 days of treatment they found no difference in results. (2)Īs we will describe in detail, the efficacy of the new short-course therapy is, at minimum, comparable to that seen with the older, longer-course trials of topical and oral antiviral therapy. We do not discuss suppressive therapy, which may be indicated for frequent or severe recurrences (6 or more per year) in immunocompetent persons, for immunocompromised patients, or as an adjunctive measure to reduce genital herpes transmission. Our review focuses on episodic treatment of acute recurrent HSV outbreaks for immunocompetent persons. (1) While this approach has not lived up to expectations for HIV treatment, it may have found its place in the treatment of recurrent herpes simplex virus (HSV) infections. That expression arose during the evolution of treatment for human immunodeficiency virus (HIV). * Patient-initiated, short-course, high-dose OAV treatment of recurrent HSV outbreaks may be as effective as the traditional, longer-course regimens. * Consider giving patients an oral antiviral (OAV) medication to self-administer when HSV prodromal symptoms occur.
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