Definitions of the levels of evidence (I, II-1, II-2, II-3, and III) and grades of recommendations (A-E and I) are provided at the end of the "Major Recommendations" field.
Recommendations
- Up to 70% of all genital herpes simplex virus (HSV)-2 infections are transmitted during asymptomatic shedding; therefore, the use of condoms is recommended to lessen the likelihood of disease transmission. (II-A)
- A laboratory-based diagnosis of genital herpes is essential for its effective management. (II-A)
- Suppressive treatment is suggested for patients who have
- At least 6 recurrences per year
- Significant complications, but fewer than 6 recurrences per year
- Their quality of life significantly affected
- Social and sexual dysfunction
- To lower the risk of transmission to a sexual partner or fetus/neonate. (II-B)
- The use of the anti-viral valacyclovir, coupled with condoms and safer sex counselling, is recommended for individuals with proven genital herpes. (I-B)
- Routine or targeted HSV screening is not indicated. (III-B)
See original guideline document for recommended regimens of episodic and suppressive treatment plans.
Definitions:
Quality of Evidence Assessment*
I: Evidence obtained from at least one properly randomized controlled trial
II-1: Evidence from well-designed controlled trials without randomization
II-2: Evidence from well-designed cohort (prospective or retrospective) or case-control studies, preferably from more than one centre or research group
II-3: Evidence obtained from comparisons between times or places with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of treatment with penicillin in the 1940s) could also be included in this category
III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees
Classification of Recommendations**
A. There is good evidence to recommend the clinical preventive action.
B. There is fair evidence to recommend the clinical preventive action.
C. The existing evidence is conflicting and does not allow to make a recommendation for or against use of the clinical preventive action; however, other factors may influence decision-making.
D. There is fair evidence to recommend against the clinical preventive action.
E. There is good evidence to recommend against the clinical preventive action.
I. There is insufficient evidence (in quantity or quality) to make a recommendation; however, other factors may influence decision-making.
*The quality of evidence reported in these guidelines has been adapted from The Evaluation of Evidence criteria described in the Canadian Task Force on Preventive Health Care.
**Recommendations included in these guidelines have been adapted from the Classification of Recommendations criteria described in the Canadian Task Force on Preventive Health Care.
