Oral HSV-2, Antibodies and Antivirals

[Hank20220805]

Hi Terri
About 2 months ago I joined that rare group of people with Oral HSV-2. I won’t go into detail, but I performed oral sex on a partner the night before they had their first out break. They must have been shedding at the time. We did not have penetrative sex.

On a reddit forum, someone referred to Oral HSV-2 as the “jackpot” of Herpes. Saying that I’m unlikely to get HSV-1 and since I have HSV-2 orally I’m unlikely to to acquire it genitally. I’ve confirmed the same information after reading several questions on your forum. But from what I understand I need to build up antibodies first.

So my question or questions revolve around developing antibodies. I understand every case is different, so I’m not asking for precise answers, just round ball-park estimates.

How long before I build up enough antibodies to avoid auto-inoculation in the boxer-short region?

I’ve just started taking Valacyclovir for suppressive therapy, will that slow down or stop the the development of antibodies? Should I stop and wait a few months?

Are there any long term implications about taking Valacyclovir for suppressive therapy?

[Terri Warren]

So I am assuming that you had a swab test that was positive for HSV 2 from your mouth, correct?
And a negative antibody test to know that this is a first infection?

How long before I build up enough antibodies to avoid auto-inoculation in the boxer-short region?
About 3-4 months

I’ve just started taking Valacyclovir for suppressive therapy, will that slow down or stop the the development of antibodies? Should I stop and wait a few months?
Yes, it will. Once you are off meds for 3 months, you should have mounted a full immune response

Are there any long term implications about taking Valacyclovir for suppressive therapy?
None that we know of, no.

Terri

[Hank20220805]

Just to confirm what you are saying on my second question. The Valacyclovir is slowing down my body’s ability to build antibodies and prolonging the amount of time it will take before I build up enough antibodies to to avoid auto-inoculation? So should I stop suppressive therapy until I’m 3-4 months out from my initial outbreak? If this is the case should I just take the recommended dosage for outbreaks when they happen while I wait?

Thanks

[Terri Warren]

I would say yes, and treat outbreaks as they come up. But if you are having sex with an uninfected person, the risk of transmission is greater off meds.

Terri

[Hank20220805]

Thank you for being such a valuable resource here.
I’m trying hard not to obsess over this, but I’m confused about one aspect of the interaction between antivirals and the development of antibodies.

Assuming that I stop the suppressive therapy today, what happens 3-4 months from now after I develop enough antibodies to avoid self-infection (genital, herpetic whitlow, etc…), then start the suppressive therapy (Valacyclovir)? Are those antibodies permanent or will the antivirals diminish the strength of those antibodies and eventually restart the clock at day 1 making the prospect of self-infection a possibility all over again 6 months from now?

I’m just wondering if when I start taking antivirals for suppressive therapy again in 4 months will that counter the benefits of developing antibodies. I guess the question really is, once I develop antibodies are they here to stay or is this a process that needs to remain constant for me to experience their benefits? And will antivirals counter those benefits?

I hope I’m not being too confusing here. Just trying to gather all the information I need to live a happy and healthy life going forward.

thank you

[Terri Warren]

those antibodies that you develop after 3-4 months are permanent, yes. Taking antivirals in four months will simply quiet the virus and reduce the risk of viral replication. Antivirals will not interfere at that point with your own immune response.

Terri

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