Valacyclovir reverse effects

[Healthylife446]

Hi Terry!

I (34/f) have had confirmed HSV2 (buttocks/anally) for 9 years

For the first 6 years I took valacyclovir as a daily suppressant (500mg/daily, 1g if feeling prodrome, 1g/2x day if outbreak). Just recently over the past 8 months, I stopped taking valacyclovir completely to see what would happen (my outbreaks while on daily suppressive treatment were 1-2 a year and always very mild). I now treat my HSV2 episodically since stopping the suppressive regime (outbreaks still very sparse, little to no prodrome).

I have recently started dating again, and thus have started using valacyclovir again as a daily suppressive (500mg) to reduce the possibility of transmission to HSV(-) partners

Now I’m experiencing daily prodrome (nerve tingling, surface itching, some soreness) but no outbreaks. I feel like the valtrex is having the opposite effect now since I’ve resumed taking it. This is confusing and I’m not sure how to protect potential partners from getting HSV2 from me (condoms will always be used)

Should I go back off the Valacyclovir, and only treat episodically? Am I putting sexual partners at higher risk if I do not take suppressively? I rely on the prodrome to determine when to refrain from sexual activity

Should I try to get used to the prodrome caused by being back on valacyclovir, and trust that I’m not as contagious (as I feel)?

Two last questions, regarding oral sex:

-Can I pass HSV2 (I have it genitally, no oral HSV whatsoever) to someone if I am performing oral sex on them, and they are HSV(-)?

-Conversingly, can I pass HSV2 to someone if they perform oral sex on me? I’ve heard of the possibility of non-positive partners contracting HSV2 orally, but that it is extremely unlikely

Thank you so much!

[Terri Warren]

Should I go back off the Valacyclovir, and only treat episodically? Am I putting sexual partners at higher risk if I do not take suppressively? I rely on the prodrome to determine when to refrain from sexual activity
Episodic therapy does not deal with asymptomatic viral shedding. It seems really unlikely to me that valacyclovir is causing you to shed more often, there just isn’t a biologic reason for that.

Should I try to get used to the prodrome caused by being back on valacyclovir, and trust that I’m not as contagious (as I feel)?
I think yes, as my best guess

-Can I pass HSV2 (I have it genitally, no oral HSV whatsoever) to someone if I am performing oral sex on them, and they are HSV(-)?
No, not if you only have it genitally

-Conversingly, can I pass HSV2 to someone if they perform oral sex on me? I’ve heard of the possibility of non-positive partners contracting HSV2 orally, but that it is extremely unlikely
That is also very unlikely but not impossible like the previous question and answer.

Terri

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