HSV-1 outbreak and suppression

[question123]

Hi Terri,

I was diagnosed with genital hsv-1 four months ago. I have been on suppressive therapy for three months (500mg of valtrex, once a day.) I had a recurrent outbreak a few days ago, horrible fever and two tiny, non painful, barely noticeable red bumps around my labia and significant tingling. I bumped my valtrex to twice a day for three days. Fever has resolved, but still feeling weak and now have cold-like symptoms (runny nose, cough). During my initial outbreak I did not have a fever, although my outbreak was closer to an hsv-2 outbreak as far as the other symptoms go (painful blisters etc.)

I was under the impression that genital hsv-1 had way fewer outbreaks ESPECIALLY while on suppressive therapy.

My main question- I have read in some places that sometimes 1 gram of valtrex a day is prescribed instead of 500mg. Do you think I need to boost my daily dosage? Im particularly concerned because my partner is negative for hsv-1 and although we use condoms 100% of the time and abstain during outbreaks, I would like to make sure I am being as cautious as possible. In the last two weeks I was ill with bacterial vaginosis and was on anti-biotics. Could being ill have triggered an outbreak? Or is my body just getting used to all of this? I am rather new to this, and although I know my hsv status, I didn’t expect an outbreak due to my suppressive therapy and virus type/ location (1, genitals), especially one with a fever. Any feedback/ insight on suppressive therapy dosage and outbreak triggers would be helpful. Thanks so much for reading.

• This topic was modified 8 years, 9 months ago by question123.
• This topic was modified 8 years, 9 months ago by question123.
• This topic was modified 8 years, 9 months ago by question123.

[Terri Warren]

Yes being ill could certainly trigger an outbreak. However, I don’t consider BV “being ill”. A fever with recurrence seems pretty unlikely but certainly possible. Cold symptoms are not part of herpes either. I’m wondering if maybe the fever and cold symptoms were actually something completely different than the herpes outbreak? I also wonder if the bumps were actually herpes. Are you pretty sure about that?

However, in the beginning of being infected, it does take a while for the immune system to fully kick and do it’s job as it gets familiar with the virus.

So I take it that this is a different partner than you were with when you were first diagnosed?

You could certainly bump to 1 gram (or better, I think, 500 mg twice a day rather than once a day). And you could do that for a year or so while your immune system catches up. However, also, during that year, you will begin to get used to what symptoms are actually herpes and which might be other things.

Please let me know if you have other questions

Terri

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