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Therapeutic Approach

Herpes simplex virus (HSV) is a common, human DNA viral pathogen. There are 2 types: HSV-1 and HSV-2, which primarily present as orofacial and genital infections. However, both types can occur anywhere on the body. Clinical manifestations vary depending on the site of infection, immune status of the host, and whether infection is primary or recurrent. Many HSV infections only require supportive care. Therapy should be based on symptoms and the site affected. In the authors’ experience, oral valacyclovir is first-line therapy for most localized infections, with IV acyclovir reserved for severe disseminated infections. Topical therapy is rarely initiated given its multiple daily applications and decreased efficacy when compared to systemic therapy. See Table 140-1.

Table 140-1Herpes Simplex Virus Treatment Table

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