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Internal Medicine

Answer 6
  1. Appropriate for patients who have 6 or more recurrences per year. Daily suppressive antiviral therapy reduces recurrences of genital herpes by at least 75% in persons who have 6 or more recurrences per year. Valacyclovir may be given once daily as suppression (at doses of 500 or 1000 mg), but acyclovir (400 mg) and famciclovir (250 mg) require twice-daily dosing. Antiviral suppression is also effective for prevention of recurrent genital lesions caused by herpes simplex type 1 infection. Severe initial episodes of genital herpes do not predict more frequent or severe recurrences. Suppressive therapy has been shown, in rare cases, to cause antiviral resistance in immunosuppressed patients but not in immunocompetent patients.

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