Vulvovaginitis herpetica recidivans - Altmeyers Encyclopedia

Definition
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Recurrent infection with herpes simplex viruses in the vulva and vaginal area.

Prolonged oral Aciclovir therapy: 4 times/day 200 mg Aciclovir (e.g. Zovirax) p.o. for 6-12 months In case of recurrence: dose increase to 5 times/day 200 mg p.o. Dose reductions to 400 mg/day or 200 mg/day can be attempted later.
Children over 2 years receive the adult dose, children under 2 years receive half of the adult dose. In case of resistance to therapy Foscarnet(e.g. Foscavir) 40 mg/kg bw every 8 hours as a 1 hour infusion over 7-10 days depending on the clinic.
Immune stimulation with autologous blood treatments: collection of venous autologous blood with immediate, deep intramuscular injection in increasing amounts (initially 2 ml/week, weekly increase by 2 ml to 10 ml. Injection every 14 days for 3 months).
Inosine (e.g. isoprinosines) 6-8 times 1 tbl/day p.o.

In particular in recurrent infections, the external application of interferon alfa has been shown to be successful in some cases .

Corey L et al (2004) Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med 350: 11-20
Erlich KS et al (1989) Foscarnet therapy for severe acyclovir-resistant herpes simplex type 2 infections in patients with AIDS. Ann Internal Med 110: 710-713
Kaplowitz LG et al (1991) Prolonged continous acyclovir treatment of normal adults with frequently recurring genital herpes simplex virus infections. JAMA 265: 747-751
Maccato ML (1992) Herpes genitalis. Dermatol Clin 10: 15-22
Villa A et al (2003) Genital herpes infection: beyond a clinical diagnosis. Skinmed 2: 108-112