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Herpbegone

HSV-1 frequency increased on suppressive valacyclovir?

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Herpbegone

I have had HSV-1 for about 5 1/2 years. My primary outbreak was horrendous:painful swelling in lips, lymph nodes, and throat, and 5-6 sores on lips and cheeks. After that episode, I was prescribed valtrex to take episodically. Other than taking it once or twice when I thought I had a tingle, I was cold sore free for the first 4 years after my primary episode. I thought maybe it would never come back. Then all of the sudden about a year and a half ago, I had a bad recurrence. I didn't catch it in time for Valtrex to help and the swelling on the lips was so bad I couldn't close my mouth fully. Since that time, I've had probably 5-6 outbreaks and the last two have happened after going on a dose of 1 g/day for suppression.  Here are my questions:

 

1) Have other people experienced long periods without recurrence followed by periods of high virus activity? Is this the new norm or should I expect some years "on" and some "off"? I can't  identify an obvious trigger for this year and a half that the virus has been so active and I can't understand why I didn't have outbreaks the first 4 years after that primary episode.

 

2) I originally had brand name Valtrex after that first outbreak but I have been on generic valacyclovir for suppression. I know there shouldn't be a difference, but does anyone know if there is evidence that  brand name Valtrex is better and why? Or should I try acyclovir? I actually pushed for valacylovir because I have had acyclovir once and felt it gave me headaches. But I think my doctor usually prescribes acyclovir for suppression, so I'm willing to try if there's evidence it is better. I have seen some forum discussion about other drugs, but most of them seem to be hard to get a hold of or insanely expensive.

 

3) Since going on the 1 g/day for suppression four months ago, I've had two outbreaks. I think this is probably more frequent than before.  Between outbreaks I feel like one might be coming the majority of the time-tingling, and general nerve pain/sensations. This has actually made me more paranoid on a constant basis than I was when I didn't take daily suppression. And the outbreaks are different than the outbreaks I had before. They do swell less and heal faster (about 7 days vs 10), but they are now popping up in different places on my lips. The last time I got a sore at the original site and then another sore on the other side of my bottom lip at the same time. Today I have rapidly developed a cluster of sores on my upper lip but no sign of sores at the primary site on the bottom lip...it almost feels as if the virus is trying to pop up wherever it can. I don't know if I'm just making all this up about the constant prodrome like symptoms and if it's just a coincidence that the recurrences seem to be in different locations while on 1 g/day, but I just wanted to know other people's experiences with suppression, particularly of HSV-1. I don't know whether to stop and go back to episodic treatment, to switch to acyclovir, or what. I'm very discouraged by the fact that it seems to be getting more and more frequent over the last year and a half. 

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