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My partner has gotten cold sores since childhood and is not taking antivirals. I have taken three IGG tests over the last five years, all of which were negative for both HSV1 and HSV2, so I understand that I am fully susceptible to becoming infected.
In the morning, about five days ago, my boyfriend and I engaged in foreplay prior to sex which included intimate kissing and him licking and rubbing my nipples, which then lead to him stimulating my clitoris with his fingers (no oral sex). It was dark during the time we were sexual and we fell asleep for about two hours afterwards. After waking up in the light, we noticed that he had a red spot above his lip which was starting to swell. Over the next few hours, a definite cluster of blisters was forming. He did not feel any of the typical sensations he associates with cold sores above his lip while we were intimate, but due to the room being dark, I am unsure if the redness was present at that time.
I understand that I have more than likely been exposed to HSV orally. I am concerned that I may have also been exposed genitally from his saliva being on my nipples when he touched them with his fingers before he stimulated my genitals, since those things happened within a relatively short amount of time.
1.) Do you believe that I am also at a likely risk of genital exposure?
I have taken valaciclovir daily since the evening after the exposure as prescribed by my doctor.
2.) Will taking the valaciclovir as a suppressive therapy prevent me from developing an adequate amount of antibodies to protect me from autoinoculation of other body parts and potential exposures in the future? Or will it just delay that process? I would like to keep taking it if it will reduce the chance of getting a severe primary outbreak and future symptomatic outbreaks, but I want to know if it would put me at a higher risk of the above types of complications.
I understand that the typical incubation period for a primary outbreak is from 2 to 14 days.
3.) If I do not get symptoms within the next two weeks, is that still a good sign that I will not get a primary outbreak? I know that it is possible for people to experience their first noticeable outbreaks long after they have been exposed, but I am wondering how I compare to the typical timeframes considering that I’m taking antivirals.
4.) Will there ever be a significant amount of time that passes for me to get an accurate blood test while taking valaciclovir?
5.) Will discontinuing the valaciclovir put me at an increased risk of severe symptoms due to its previous reduction of antibody production, or will I still be producing adequate antibodies on the valaciclovir, just theoretically less since there is theoretically less virus for my immune system to react to?
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1.) Do you believe that I am also at a likely risk of genital exposure?
I really do not, no.
I have taken valaciclovir daily since the evening after the exposure as prescribed by my doctor.
2.) Will taking the valaciclovir as a suppressive therapy prevent me from developing an adequate amount of antibodies to protect me from autoinoculation of other body parts and potential exposures in the future? Or will it just delay that process? I would like to keep taking it if it will reduce the chance of getting a severe primary outbreak and future symptomatic outbreaks, but I want to know if it would put me at a higher risk of the above types of complications.
I understand that the typical incubation period for a primary outbreak is from 2 to 14 days.
I don’t really think that taking the valcyclovir daily will be effective in warding off future infection when taken on a regular basis, no. I might make a bad primary less likely, true, but not ward off infection completely.
3.) If I do not get symptoms within the next two weeks, is that still a good sign that I will not get a primary outbreak? I know that it is possible for people to experience their first noticeable outbreaks long after they have been exposed, but I am wondering how I compare to the typical timeframes considering that I’m taking antivirals.
I don’t believe we can compare you to typical timelines since you are taking daily antiviral therapy. You could certainly acquire HSV 1 without symptoms, and that is more likely, I think, due to the daily medicine.
4.) Will there ever be a significant amount of time that passes for me to get an accurate blood test while taking valaciclovir?
I don’t think so, no.
5.) Will discontinuing the valaciclovir put me at an increased risk of severe symptoms due to its previous reduction of antibody production, or will I still be producing adequate antibodies on the valaciclovir, just theoretically less since there is theoretically less virus for my immune system to react to?
Yes, if you did acquire herpes and are not taking medicine, yes, your symptoms would likely be more severe.
You should know that the usual screening test for HSV 1 misses 25% of infections, compared to herpes western blot. So it is possible that you are already infected and the test has not picked it up.
Terri
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No, discontinuing Valtrex now I don’t think would cause you to have more severe symptoms than if you had not taken it at all. is that your question?
Yes, technically I think you are at a slightly greater risk of autoinoculation longer that if you were not taking medicine, but the medicine itself will keep the virus quiet so that, I think decreases the risk. Overall, it is probably a wash.
Yes, stopping it now would return you to the normal time frame for testing. One week is not going to confuse the testing. Also, if you get an outbreak, you can have the PCR tested.
I don’t know the answer really to that next question.
Yes, I do, to the last question
Terri
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Just to clarify your answer to my last question, you mean that the Valtrex will indeed still have the same effectiveness if I need to take it in the future?
Yes
I decided to stop the Valtrex after taking it for a week since I am not completely certain whether or not I was infected.
That’s fine
It is important for me to know my status. The last time I took an IGG test was in July of 2014. I plan to take an IGG again in a couple months to see if it comes up postive.
Sounds like a good plan to me
However, I did not realize that IGG tests have such a high rate of false negatives for HSV1.
Yup they do. new research.
If this next test is negative, how long would I need to wait (from the date of exposure) to take the Western Blot and how would I start the process of ordering it?
The western blot should be drawn 16 weeks after last possible infection. You just need to call our clinic to set up a phone consultation when the timing is correct. We can arrange the rest.
Terri
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