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bestfootforward

Does Medication Have Benefit If OB's Are Seldom & Mild?

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bestfootforward

Hi all,

I've had HSV-1/oral herpes for almost six years now. Fortunately, I've been blessed where I only average about one outbreak a year, and that outbreak isn't so bad ... just looks like an infected pimple or something near my lip.

Anyway, given that my outbreaks are so infrequent and not really that major on a pain or unsightliness scale (not that I love having it appear for all the world to see, but I deal with it), I'm wondering if I actually have anything to gain by starting Valtrex suppressive therapy or some other type of medication.

I've searched high and low for any research, data, or studies that provide actual numbers on how effective suppressive therapy is in terms of reducing your shedding rate, but I can't find anything. Hypothetically speaking, given my oral herpes outbreak history, let's assume my shedding period is 10% out of any given year. Will suppressive therapy drop that percentage down to 5% or less? If so, is that even worth it if I have to factor in any potential side effects of this medication? Is there any guarantee that suppressive therapy will decrease the shedding rate at all? What's a statistically significant decrease in shedding rate?

I'm not a fan of putting drugs or any kind of medication into my body unless it definitely has specific benefits and value. Therefore, I'm just trying to figure out if I have anything to gain from beginning suppressive therapy or, if based on my once-a-year OB history, I should just let it be since it seems my body's immune system is fighting the virus pretty effectively on its own.

Lastly, if anyone knows of research or a study that highlights the estimated decrease in shedding and/or OB's over a period of time, I would really like to find that information. Does the oral herpes shedding rate differ from the genital herpes shedding rate? Is it assumed that the shedding rate decreases by 10% or some other percentage each year after the initial outbreak? I know this information is probably person-specific and varies on a case-by-case basis, but I'm still interested in getting a broader sense of understanding.

Any and all experience- and fact-based feedback is greatly appreciated.

Many thanks,

bestfootforward

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ntdc

Since valtrex has similar activity against hsv-1 its effect on suppression of outbreaks and shedding is probably similar to the hsv-2 studies.

The only studies I found showed suppressive valtrex was of use in preventing clinical reactivation (clinical outbreaks) those who contracted HSV-1 through contact sports (wrestlers herpes).

If you have one outbreak per year, honestly it is probably not cost effective for you to use valtrex and likely that the potential side effects and cost outweigh any benefit for you.

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bestfootforward

Thanks ntdc. I really appreciate you sharing what you know. I'm inclined to agree with you. I was mostly motivated in exploring the suppressive therapy option only if it meant that I could greatly reduce the chance that I pass oral herpes on to a non-infected partner through shedding anyway.

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KillThisBeast

If I were in your situation, I would get a prescription for Valtrex in case of an OB only, not for suppressive treatment.

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blackwatch

I think this is an excellent question. In my case I used to have very frequent OB's. However it is now 10 months since my last outbreak and another 10 months for the one prior to that. Is there any way for me to know how much I am shedding. If say I get to 18 months or even 2 years without an outbreak does that mean my shedding is practically non existent? By the way it is 10 months without any special remedy, ie no medication and no Purell. :)

Ideally if I could find out how much someone sheds if he has an OB every 10 months, 12 months, 18 months, etc. It would quite helpful.

Any guidelines on this would be much appreciated.

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KillThisBeast
Is there any way for me to know how much I am shedding. If say I get to 18 months or even 2 years without an outbreak does that mean my shedding is practically non existent?

I would say even if you haven't had an outbreak in 10 years, you could still be contagious. Theoretically, the body cannot defeat herpes, only suppress it. The fact that you still have outbreaks (albeit infrequently) is proof that you shed the virus enough to be contagious. It is impossible to predict when we aren't shedding.

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annyi

Isn't it true though everytime we have prodrome before an OB? If the virus is supressed to nerve ends, it is supposely not to be contagious, right? When it replicates, we would feel the nerve pain, or itch, or any nerve sensation---because it is nerve related---you just need to be careful and sensitive enough to feel it. If we were constantly shedding, then anytime we could be contagious, then how can we explain the only 4% infection rate between couples that don't use condom when the partner with herpes don't have symptoms? If we can find out more on this would be a great help!

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