Oral HSV-2 shedding and suppressive medication

[Questionthevoid]

I am a 30 y/o male who received Oral HSV2 from my former partner about six and a half years ago. I am newly single and have a question about shedding/transmitting and suppressive meds. My first outbreak in Feb 2017 was very bad with flu like symptoms I had to be hospitalized for. After this, I got about one or two cold sores on my lips per year. Never had a genital one. I have been taking one 500mg Valtrex once a day for about 10 days now. My question is twofold:

1. I have heard that Oral HSV2 has a lower transmission rate compared to other forms. Is this true, and does what we know about Oral HSV2 transmission say anything on if it’s more or less likely with different transmission areas (eg, my lips to her lips, or my lips to her genitals.)?

2. Is suppressive Valtrex at the 500mg/1x per day enough to make this risk even less? I have seen people mentioning taking much more than this on here, so I’m wondering if I should try to up my dosage.

Thank you so much.

[Terri Warren]

1. I have heard that Oral HSV2 has a lower transmission rate compared to other forms. Is this true, and does what we know about Oral HSV2 transmission say anything on if it’s more or less likely with different transmission areas (eg, my lips to her lips, or my lips to her genitals.)?
I would first ask you if you actually had a swab test that was positive for oral HSV-2. The reason I ask is that it is extremely atypical for someone with oral HSV-2 to get recurrent cold sores yearly. Most often, HSV two oral infection remains asymptomatic. It is certainly possible you are an exception here.

2. Is suppressive Valtrex at the 500mg/1x per day enough to make this risk even less? I have seen people mentioning taking much more than this on here, so I’m wondering if I should try to up my dosage.
500 g of Valtrex daily should reduce both viral shedding and the frequency of recurrence is that you are having. I don’t see any reason to take a higher dose at this time.

Terri

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