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Prophylactic Acyclovir (like PrEP) for HSV2 negative partners


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Hi all-

Is it possible that daily acyclovir taken by HSV2-negative individuals would reduce the risk of contracting HSV2 in a discordant relationship? Or would it least be possible to help to prevent an uninfected partner from developing symptomatic HSV2?

Essentially, the constant acyclovir in their system would allow help a person's immune system to fight off HSV2 during exposure. And either they would not seroconvert, or they would seroconvert but be asympomatic because their body effectively challenged the virus upon encountering it and the virus was only able to affect very few nerve cells during the primary infection. 

I am not saying any of this is true, but am looking for input: why or why not would this work in the same way that PrEP significantly reduces the risk of contracting HIV?

I feel like I have heard this question bandied around and have never heard any scientifically feasible arguments or comments as to why this either might or might not work. So if anyone can give scientifically-grounded commentary here, it would be much appreciated.

(I apologize in advance if this is not the right forum for this post, but I am posting here because I think the people that read this forum are the most scientifically informed and might be able to comment.)

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HSV antivirals do not fight the virus directly. They work by removing DNA building blocks for HSV viral replication. Hence it is not believed that there is any value in terms of preventing an infection which comes from live virus from the carrier, but it is likely the infection would be lessened if one occurred. 

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As Wilso said, antivirals cause errors or breaks with newly formed viral DNA.  I won't affect the virus that is already formed in the system.  If exposed to HSV, the antivirals would do nothing to it.

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    • EssenceL25
      I’m going to force him to get tested ! Thanks for your help ! 
    • WilsoInAus
      @EssenceL25 there really isn't a question mark around the source, it's your latest partner. The median time from infection to an outbreak of lesions upon initial infection is 4 days.  The only thing that isn't certain is the type I suggest.
    • EssenceL25
      I asked if it was hsv 1 or 2 and the doctor said it was Hsv2. I’m not sure i just asked him when he was tested last he said this year I said I think we should go test together and he agreed . I’m going to bring it up again cause I really need to know if he gave this to me I wasn’t sure since it was so close to my previous relationship.
    • WilsoInAus
      @EssenceL25 then it is all beyond reasonable doubt that the current partner is the source. A 'perfect' fit in terms of timing, symptoms and swab. It may be though that the type is not technically known. Culture swabs are very often not typed and just assumed to be HSV-2 if taken from a genital location. If you received oral sex in the days leading into 7 March then it is 50/50 as to whether this is HSV-1 or HSV-2. You could contact your doctor and confirm if the swab was actually typed (which is a second test where fluorescent antibodies for HSV-1 and HSV-2 are added and see which one 'glows').  If that test wasn't done then you do not know type. If you have oral HSV-1 yourself (cold sores) then this will be HSV-2. Does your partner have oral HSV-1? It is somewhat strange for him not to rush and test - many people have a 'reaction' if they truly do not know their status and have concerns that you infected them etc. (not initially rational of course). This indicates he may know his status - or maybe he just isn't simply the sharpest tool in the shed!?
    • EssenceL25
      I had flu like symptoms and ulcers on my vagina . They did a culture and I tested positive for hsv2. I asked my partner to get tested he agreed but I’m not sure if he will cause he hasn’t said anything else about it. 
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