GHSV1 treatment/antibodies/transmission

[Aa19]

23 year old male and had my initial outbreak (consisting of 6/7 sores and took awhile to fully heal the skin but no pain) roughly 6 weeks ago and was swab tested and unfortunately positive for ghsv1. At the urgent care visit where I was swabbed they gave me 10 days of acyclovir (3x daily) to start immediately and then two acyclovir a day as suppressive to take until I could get a doctors appointment. I took the suppressive doses of Acyclovir for 3 weeks following the first 10 day batch prescribed and instructed by urgent care. I went to my primary doctor (2 weeks ago) and he said to stop taking the antivirals immediately and see what happens but I can go on suppressive therapy at any time if I would like. He mentioned if you go on suppressive antivirals right away often times you have an outbreak as soon as you stop and may not build as strong of antibodies for life. It has mentally been an extremely difficult 6 weeks.

Would you recommend taking suppressive antivirals starting now for the first 2 years until shedding rates go down to 1.3%, taking now for a year and stopping for a couple months to see what happens, or not taking any at all and waiting until a possible next outbreak? If you do not recommend starting antivirals yet please recommend when you would. I am worried about suppressing so quick and not allowing antibodies to develop and in a perfect scenario have no reoccurrences. I would like to be sexually active again at some point but am worried about transmission.

Appreciate your help and all that I have learned from the forum in such a short time! It is very hard to find reliable information outside of this forum and the researchers you mention.

[Terri Warren]

I’m not in full agreement with your doctor. But if you go on suppression now, I don’t think the two-year statistic applies as you will be slower to make antibodies. But since you have an accurate swab test diagnosis, does it matter? Having said all of that, most people with genital HSV 1 don’t require suppression due to the infrequent recurrences that you will have, especially after the first year of having HSV 1. It would be fine not to take suppression right away, but you will be shedding more virus in the first six months or so of being infected, so if you are having sex with a susceptible partner, be sure to use condoms.

terri

• This reply was modified 2 weeks, 6 days ago by Terri Warren.

[Aa19]

Thanks for the response! That makes things more clear.

I guess my follow up question is would your recommendation be to start suppression or wait as long as possible and refrain from any sexual activity? I am worried about transmission (so would be taking them for this reason) but I don’t want to jeopardize the future as hopefully in a couple of years I won’t have breakouts and the odds of me transmitting/shedding ghsv1 will be close to that 1.3% (or low towards that).

[Terri Warren]

I think you can hold off suppression UNTIL you start having sex again, or, you can use condoms every time – they reduce transmission by 96%. If you have another outbreak, you can treat it episodically.

Terri

[Aa19]

Hi Terri,

I have been off antivirals for 3-4 weeks and most days will have red dots/pink skin across many spots in the genital area with sensitivity/slight itchiness but never any blisters or lesions. Are these symptoms an outbreak or is just my body not able to fully suppress the virus? Will these go away over the coming months as my body gets used to the virus?

[Terri Warren]

There is no way to know for sure unless you have swab testing done. I think you should do that so you know, with this presentation on my skin, I’m either a) shedding or b) not shedding. Anything else, honestly, is just a guess.

Terri

[Author]

Posts