Recently the CDC updated its guidelines for treating sexually transmitted diseases (STDs).1 In last month's issue (CONSULTANT, June 2002, page 849), the recommendations for managing sexually transmitted bacterial diseases were discussed. Here the focus is on genital herpes simplex virus (HSV) infection and human papillomavirus (HPV) infection. In a future issue, sexually transmitted fungal and protozoan infections, as well as pediculosis pubis and scabies, will be addressed.
Highlights of the new guidelines for treating viral STDs, which are provided below, include:
• Renewed emphasis on counseling for patients with genital herpes and those with HPV infection.
• Improved type-specific serologic tests for HSV.
• Updated dosing recommendations and alternative regimens.
• Tips for follow-up.
1. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR. 2002;51(RR-6):1-80.
2. Fife KH, Barbarash RA, Rudolph T, et al. Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection: results of an international, double-blind randomized clinical trial. Sex Transm Dis. 1997;24:481-486.
3. Reitano M, Tyring S, Lang W, et al. Valaciclovir for the suppression of recurrent genital herpes simplex virus infection: a large-scale dose range-finding study. J Infect Dis. 1998;178:603-610.
4. Chosidow O, Drouault Y, Leconte-Veyriac F, et al. Famciclovir vs aciclovir in immunocompetent patients with recurrent genital herpes infections: a parallel-group, randomized, double-blind clinical trial. Br J Dermatol. 2001;144:818-824.
5. Diaz-Mitoma F, Sibbald RG, Shafran SD, et al. Oral famciclovir for the suppression of recurrent genital herpes: a randomized controlled trial. JAMA. 1998;280:887-892.
6. Loveless M, Harris W, Sacks S. Treatment of the first episode of genital herpes with famciclovir. In: Programs and abstracts of the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy; 1995; San Francisco.