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HSV Suppression Annual Review — SCE Infectious Diseases MCQ

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EasySTIsHSV Suppression Annual ReviewSCE Infectious Diseases

A 35-year-old woman presents with recurrent genital herpes (8 episodes per year). She is started on suppressive Aciclovir 400 mg BD. After 12 months, she is episode-free. Should suppressive therapy be continued?

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Correct answer: D — Discontinue after 12 months to reassess recurrence frequency — many patients experience a natural decline over time; restart if recurrences resume at a high rate

BASHH recommends annual review with trial discontinuation of suppressive therapy after 12 months. Many patients experience a natural decline in recurrence frequency over time (particularly after the first 2 years of HSV-2 infection). If recurrences resume at ≥6/year after stopping, suppressive therapy should be restarted. Some patients require long-term/lifelong suppression. The trial of discontinuation allows reassessment of the need for ongoing treatment.

Reference: BASHH 2014 – Genital herpes; NICE CKS 2024