Suppressive antiviral therapy for genital herpes in late pregnancy
Suppressive antiviral therapy for recurrent genital herpes simplex virus (HSV) infection during late pregnancy reduces the chance of HSV recurrence at delivery and therefore the need for Caesarean section.
A higher-frequency dosing regimen of suppressive antiviral therapy is recommended from 36 weeks gestation until delivery, because plasma volume is increased. UseAustralian Society for Infectious Diseases (ASID), 2022Ong, 2023:
1aciclovir 400 mg orally, 8-hourly, until delivery. For dosage adjustment in adults with kidney impairment, see aciclovir oral dosage adjustment aciclovir aciclovir aciclovir
OR
1valaciclovir 500 mg orally, 12-hourly, until delivery. For dosage adjustment in adults with kidney impairment, see valaciclovir dosage adjustment. valaciclovir valaciclovir valaciclovir
Suppressive antiviral therapy for genital herpes may not always protect against HSV transmission to neonates; see Neonatal herpes simplex infection.