Herpes simplex virus

Updated: September 17, 2022

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

cidofovir

Acyclovir resistance:

mg/kg

Intravenous (IV)

once a week for 3 weeks
For mucocutaneous infection: Apply 1% Topical gel (cidofovir) once a day for 5 days

Dose Adjustments

Dose adjustments for renal impairment:
CrCl >1.3 ml/min: 5 mg/kg
CrCl 1 to 1.2 ml/min: 4 mg/kg
CrCl 0.8 to 0.9 ml/min: 3 mg/kg
CrCl 0.7 ml/min: 2.5 mg/kg
CrCl 0.5 to 0.6 ml/min: 2 mg/kg
CrCl 0.4 ml/min: 1.5 mg/kg
CrCl 0.2 to 0.3 ml/min: 1 mg/kg
CrCl 0.1 ml/min: 0.5 mg/kg

trifluridine

Herpes keratoconjunctivitis, keratitisInitial::

drop

Instill every 2 hours into the affected eye(s) while awake (do not instill more than nine drops/day)
Maintenance (re-epithelialization occurs): 1 drop every 4 hours for seven days
mucocutaneous infection (acyclovir-resistant): HIV patients: apply 3 times topically once a day for 21 to 28 days, based on clinical response

tromantadine

Apply 1% gel topically on the affected area of skin for 3 to 5 times daily

famciclovir

250 mg orally every 8 hours for 7-10 days

inosine acedoben dimepranol

Take dose of 1 gram four times a day for one to two weeks

foscarnet

Either- 40 mg/kg intravenously every 8 hours for 14-21 days over 60 minutes
Or- 40-60 mg intravenously every 12 hours for 14-21 days over 60 minutes

trifluridine

Children > 6 years and adolescents:
Herpes keratoconjunctivitis, keratitis: :

drop

Instill every 2 hours into the affected eye(s) while awake (do not instill more than 9 drops/ days)
Maintenance (re-epithelialization occurs): 1 drop every 4 hours for 7 days (do not exceed the duration of 21 days, if the improvement is not achieved, consider therapy modification)

famciclovir

250 mg orally every 8 hours for 7-10 days

Future Trends