Genital Herpes Simplex Daily Treatment Suppressive Therapy
Daily suppressive therapy
The decision to initiate continuous suppressive therapy is subjective and is based on the frequency and severity of recurrences and psychosocial factors. Continuous daily suppressive therapy significantly reduces, but not completely suppress, the amount of asymptomatic shedding, clinical outbreaks and rate of transmission. Daily suppressive therapy reduces the frequency of genital herpes recurrences by 75% among patients who have frequent recurrences (i.e., six or more recurrences per year). Safety and efficacy have been documented among patients receiving daily therapy for years. Suppressive therapy has not been associated with emergence of clinically significant acyclovir resistance among immunocompetent patients. After 1 year of continuous suppressive therapy, discontinuation of therapy should be discussed with the patient to assess the patient's psychological adjustment to genital herpes and rate of recurrent episodes, as the frequency of recurrences decreases over time in many patients.
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