November 14, 2016 at 11:38 pm #160956042Participant
I think this question may be covered by prior payment (I had 1 original question with 1 follow-up; couldn’t figure out how to access 2nd question or how to pay for additional ?s – more than happy to do so.
I have asked similar questions previously, but have persistent anxiety. Visually diagnosed outbreak 18 mos ago (no ab test). 10 days of Valtrex 1gm BID starting 48 hrs after blisters appeared, which was 3 weeks post possible exposure. Symptoms all resolved with treatment, then off Valtrex for 2 weeks. Developed recurrent lesions with a positive HSV2 PCR test; back on Valtrex 500mg to 1 gm per day ever since. First few months were awful, but have had gradual decrease in symptoms. Have stayed on Valtrex, due to frequent minor sx (probably psychsomatic/menopausal) and to prevent transmission to partner with unclear status (his ex-wife was HSV2 positive, but he has never been tested).
Can you comment on the following:
1) it is safe to start suppressive therapy around the time of initial symptoms, and it is common practice for patients to stay on therapy for long duration (e.g. years)
2) Given that suppression is <<100% effective, especially during the first year of infection, most people eventually develop an effective immune response even on treatment, although it can take a long time.
3) What happens when suppressive therapy is discontinued? Reading through posts, it seems like you have no concerns about a severe “flare” when suppressive therapy is stopped (e.g. after 2 years or more of treatment); if an outbreak occurs, it should not be any worse than an outbreak would normally be. Is this correct?
4) Is there a risk for auto inoculation when suppressive therapy is stopped after several years?
5) Is there always an outbreak when suppression is discontinued?
Thanks so much – again, happy to pay for more questions if I owe $$
November 15, 2016 at 4:06 pm #16104Terri WarrenKeymaster
1. Its fine to take it early and for a long duration IF you have a diagnosis, which you definitely do, yes
2. yes, but I have seen it take close to a year when someone was on suppression from early on. Basically, the medicine takes the place of the immune response and then some.
3. Some people do recognize a significant outbreak after stopping suppression, but in my opinion they have just not been having outbreaks at all so the first one can feel remarkable.
November 16, 2016 at 8:48 pm #161406042Participant
Thanks so much- this is so helpful and reassuring.
November 19, 2016 at 8:40 am #16158Terri WarrenKeymaster
You are very welcome! Glad to be of help
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