2 Reduce the amount of open mouth kissing, less contact the better. She gets cold sores on her bottom lip in the middle is that the place she will shed? will it be all over her mouth? I read in the saliva? What forms of kissing would be safest?
Peck are safest, yes, and no real risk if no cold sore is present.
Peck kisses are practically 0 risk?
3 She is willing to go on antiviral It takes 5 days to reach full potency. Would you encourage to wait 5 days? Does higher dose day 1 reach full potency quicker? Found study from 2005 they took 2g dose 12 hours apart at the prodrome stage, it reduced shedding within 24 hours.
While I agree that the 2 gram doses 12 hours apart reduces shedding, waiting the five days is the safest.
4 Soap and water kills virus. if we kiss then I wash my face, would that reduce the risk? How long after contact would wash be impactful? Would chapstick create a barrier that’s harder for the virus?
Washing may help. Chapstick probably won’t
5 In some studies the rate of shedding in culture vs PCR is different. Does this mean a smaller quantity of shedding and the culture doesn’t pick up? Would this indicate the chances of transmission to a partner be lower? Is there anything that tells us the amount of virus that is needed? difficult to study, and everyone is different. Is there anything that shows taking valtrex might also reduce the quantity of virus shed?
Valtrex definitely reduces the amount and frequency of viral shedding. It appears that an adult needs about 10 to the 3rd volume to transmit but there is no way for you to know that.
6 The longer someone has it, the less they shed, but when is it not significant? 5 years? 20 years? The shedding of someone (ohsv1) who gets recurring outbreaks would be around 25% of days. Would that 25% hold true this case? Would you expect it to be less? Due to number of outbreaks or years having disease? Cut in roughly half if valtrex was taken?
We don’t have the quantification that you seek. Valtrex reduces transmission of HSV 2 by 48%, something similar for HSV 1 is likely