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Genital herpes is under-recognised and under-treated. Minor lesions are common; any recurring localised anogenital symptoms or lesions should be investigated as possible genital herpes.
Oral antiviral treatment of the first clinical episode (without waiting for results) should always be offered, regardless of the time of symptom onset. The ‘72 hour’ herpes zoster rule does NOT apply to first episode genital herpes infection.
Antiviral therapy of recurrent genital herpes may be suppressive or episodic.
Some patients prefer suppressive antiviral therapy. It is often considered for those with frequent and/or severe recurrences or associated psychosocial morbidity. Adherence to suppressive treatment reduces but does not eliminate transmission.
For those on episodic antiviral therapy, it is more effective when patients start therapy themselves at the first signs of a recurrence; this requires anticipatory prescribing (“pill-in-the-pocket” antibiotic prescription).
Neonatal HSV infection needs specialist advice on management for women with a history of genital herpes and active lesions at term and especially in the high-risk situation of a first episode up to 6 weeks prior to delivery.
Neonatal HSV infection is a rare, but potentially fatal, disease of babies, occurring within the first 4-6 weeks of life. Symptoms are non-specific and a high index of suspicion is required. Most neonatal HSV infections are acquired at birth, generally from mothers with an unrecognised first genital herpes infection acquired during pregnancy.
The special authority and Hospital Medicines List restriction were removed from 1 March 2016 (Pharmac). This is recommended first-line treatment.
Prescribe enough tablets for patients to be able to self-initiate treatment at the onset of symptoms.
Only recommended for people with HSV confirmed on testing. Given daily to prevent recurrences and reduce asymptomatic shedding. Suggest prescribing for 12 months, followed by a break of 3 months to see if recurrences are still frequent and/or bothersome.
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If you would like to get a print copy of the information booklets, fill out the form on the health professionals' request for printed materials
This website is brought to you by the Sexually Transmitted Infections Education Foundation (STIEF) - an initiative funded by the Ministry of Health through collective District Health Boards (20) to educate New Zealanders about STIs. District Health Boards (DHBs) are responsible for providing or funding the provision of health services in their district.
The medical information in this website is based on the STIEF Guidelines for the Management of Genital Herpes in New Zealand. The New Zealand Ministry of Health supports the use of these clinical guidelines, developed by clinical experts and professional associations to guide clinical care in New Zealand.
The Guidelines are a consensus opinion of the STIEF Professional Advisory Group (PAG). The PAG has representation from nationwide medical, nursing and allied disciplines involved in the management of STIs. The Guidelines are produced by considering available literature, both New Zealand wide and international, and by basing the medical recommendations on the evidence in the literature or reasonable supposition and opinions of medical experts.
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