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Genital herpes (HSV): first episode, recurrence, suppression

A detailed Australian summary of genital herpes (hsv): first episode, recurrence, suppression, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Confirm a first episode with lesion PCR where possible and assess pain, urinary retention, neurological symptoms, pregnancy and immune status. Start antiviral treatment promptly for a first episode under the Australian STI guideline while also providing analgesia and urinary support. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:Australian STI Guidelines

The Bottom Line

  • Confirm a first episode with lesion PCR where possible and assess pain, urinary retention, neurological symptoms, pregnancy and immune status.
  • Start antiviral treatment promptly for a first episode under the Australian STI guideline while also providing analgesia and urinary support.
  • PCR sensitivity falls as lesions heal, so a negative late swab does not completely exclude a clinically compatible episode.
  • Explain asymptomatic shedding, recurrence, condoms, disclosure, partner testing limitations and episodic versus suppressive treatment options.
sources for this section:Australian STI Guidelines

Practical clinical workflow

1

Topic-specific assessment action

Confirm a first episode with lesion PCR where possible and assess pain, urinary retention, neurological symptoms, pregnancy and immune status.
2

Topic-specific diagnostic action

Explain asymptomatic shedding, recurrence, condoms, disclosure, partner testing limitations and episodic versus suppressive treatment options.
3

Topic-specific management action

In pregnancy, notify obstetric care because acquisition timing and lesions near birth change maternal and neonatal management.
4

Topic-specific follow-through

Routine blood serology has limited value for diagnosing the cause of a current lesion and requires careful interpretation.
sources for this section:Australian STI Guidelines

Safety boundaries and escalation

  • Urinary retention, meningism, disseminated lesions, severe immunocompromise, eye involvement or a sick neonate requires urgent hospital assessment.
  • Suppressive therapy can reduce recurrences and transmission concern and should be reviewed periodically against the person鈥檚 goals.
sources for this section:Australian STI Guidelines

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:Australian STI Guidelines

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:Australian STI Guidelines

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Australasian Society for HIV, Viral Hepatitis and Sexual Health MedicineAustralian STI Management Guidelines for Use in Primary CareLiving web guideline checked 2026-08-20 路 accessed 2026-08-20
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