Herpes Simplex Virus (HSV)

Herpes simplex virus infections

Treatment

Diagnosis: antigen testing / PCR / culture of swab / CSF / biopsy. Clinical appearance of skin lesions not reliable

During treatment: monitor renal function, adjust drug dose in renal impairment

  Drug / Dose Comments
Initial and recurrent genital/
mucocutaneous HSV
  See Sexual and Reproductive Health of Men and Women Living with HIV
Severe mucocutaneous lesions aciclovir 
5 mg/kg tid iv
After lesions begin to regress, switch to oral treatment for 21-28 days or longer, until lesions have healed
Encephalitis aciclovir 
10 mg/kg tid iv
14-21 days
Aciclovir resistant mucocutaneous HSV infection foscarnet 
90 mg/kg bid iv
Until clinical response If foscarnet is not available, cidofovir 5 mg/kg once weekly can be used. Topical cidofovir and foscarnet can be used for external lesions