1. Do we know why people with HSV-2 are unlikely to subsequently acquire HSV-1 and is the opposite true? Are people with HSV-1 less likely to acquire HSV-2 or does it not work like that? This is just for my own bank of knowledge.
We don’t know why this is, really. And the opposite is not true. However, it is possible that having genital HSV 1 may offer some protection against acquiring genital HSV 2, but that research is not complete.
2. As I mentioned previously, I have been on Valtrex for many years, but specifically I was on 1000mg daily in the last trimester of pregnancy up until now. I am breast-feeding my daughter and supplementing with formula. In the first month after she was born I was taking 500mg twice daily (hospital directions). In the last six weeks or so I have been taking 1000mg once daily. This was inadvertent and I think in my tired state was based more on habit than anything else, as during my pregnancy and before I was pregnant I always took 1000mg once daily, which is how it has always been prescribed to me. My questions are as follows:
a.What is the difference between 500 mg twice daily or 1000mg once a day? The difference? Some people just need more drug to suppress adequately. I’m not sure what else you mean by what is the difference.
b. Will the fact that I have been taking 1000mg at once have an adverse affect on my daughter as it is more concentrated at once (or are the dosages something that affect me, as opposed to the effect on my girl through the breast milk)?
I am not aware of long term side effect from taking any dose of antiviral medicine for nursing children. It does go through to the baby in breast milk, but as far as I know there are no ill effects seen in nursing babies from Valtrex.
c. Are there any long time effects on my daughters development from this drug (and this dosage) in my breast milk given that I am on daily Valtrex and plan to breast-feed until she’s at least 6 to 8 months old? I’m worried about the long-term impact on her if I take this drug daily and continue to breast-feed. Not having outbreaks greatly reduces my stress and obsessive thoughts that I will somehow infect her, however I will discontinue the drug if it somehow affects her long term.
We do know that when newborns are given acyclovir (which is what Valtrex breaks down to), they may have a transient drop in white cells which is reversed when the medicine is stopped. Giving the medicine directly to a baby would ensure a far greater dose than coming through breast milk. Again, I think you can talk to your baby’s doc about this. A wonderful reference for information about babies and antivirals is Dr. David Kimberlin at the University of Alabama, Birmingham.