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Home Treatment Options Treatment Options Updated European HSV Management Guidelines Released

Updated European HSV Management Guidelines Released

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Clinicians on both sides of the Atlantic now have the latest guidance on the diagnosis and treatment of genital HSV. The 2010 STD Treatment Guidelines, which include recommended therapeutic regimens for genital herpes, were published by the Centers for Disease Control and Prevention (CDC) late last year; these guidelines serve as the gold standard guide for STD treatment in the U.S. A short time later, in early 2011, health professionals throughout the European Union (EU) cracked open the updated European Guidelines for Management of Genital Herpes.

The same three antiviral medications – acyclovir, valacyclovir, and famciclovir- are available both in Europe and the U.S. and dosing regimens are the same or similar in most respects, with a few differences:

  • With first clinical episodes of genital herpes, for example, the EU puts more of an emphasis on shorter courses of therapy: while the CDC STD Treatment Guidelines call for a 7-10 day course of therapy with any of the three drugs, the European recommendations call for five day regimens.
  • When using acyclovir for suppressive therapy (medication taken daily to prevent or curtail the number of outbreaks), both US and EU call 400mg taken twice each day. The EU mentions an alternative regiment of 200mg taken four times daily as perhaps being marginally more effective, but note concerns about the inconvenience of patients having to take medication so frequently.
  • The US and EU guidance both allow suppressive therapy dosing with valacyclovir to consist of either 500 mg or 1 g daily. Both guidelines instruct that patients who experience more than 10 outbreaks a year should have the higher dose.

CDC STD Treatment Guidelines are available online. Download the European guidelines on the IUSTI website.

Patel R, Alderson S, Geretti A, Nilsen A, Foley E, Lautenschlager S, et al. European guideline for the management of genital herpes, 2010. International Journal of STD & AIDS, 2011. 22(1):1-10.


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