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Long term effects of suppressive therapy?


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Are there any long term side effects of suppressive therapy?

My doctor shut down the idea pretty quickly but I can get it from Superdrug if I decide to go through with it, I’ve got an app with my gp to talk about it again first though.

I’ve only had one outbreak but my anxiety over having it again is unbearable. I’m scared of accidentally giving it to somebody in my family. Every sensation I have down there has me running to the bathroom to check. It’s all I can think about. I’m getting on really well with this boy and I’ve read that supressibe therapy and condoms can reduce the risk of transmission drastically. This fact would make having that conversation, if I ever get to that point, so much easier.

So are there any long term side effects? Anything I should be worried about? Is there a risk of building immunity etc? How long could you realistically take it for, could you take it for your whole life? I’m 21 and feel like this is my only hope.

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Tired of waiting

I do not think there are many side effects to a suppressive therapy? so if that is what you want to do then go for it, or a modified one where you take when you plan on being sexually active. I think the drug kicks in within hours of taking it so. my understanding is Valtrax interrupts the replication process of the virus, by denying is resources to create new copies of it self.  Its not like antibiotics where if the full dose is not taken, it results in a weakened bacteria survive to develop a resistance to the drug.

At 21, your world is not over, the will most likely be cure within the next 5-10 years. plenty of time to sort your self out. 

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IcantThinkofaName
2 hours ago, Slkxx said:

My doctor shut down the idea pretty quickly but I can get it from Superdrug if I decide to go through with it, I’ve got an app with my gp to talk about it again first though.

my dr was pushing it on me- the suppressive daily therapy due to too many OBs. I was at first just taking during OBs, or perceived OBS when I could catch it in time (I rarely caught it in time to head it off at the pass) I finally agreed to do daily suppressive for year. Now I am afraid to stop taking it...my year will be up in Sept. What were his/her reasons to not give you suppressive therapy?

Its a good idea if you are in sexual relationship with a Non-HSV person...thats for sure.

It makes me dehydrated...drink a lot of water with it. Maybe sinus stuffiness...but that could be from other things too- hard to say. However it affects people differently. I wish I didn't have to take it. I wish I could  go back in time and never have gotten this shit.

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Theysaylifegoeson

I wonder why your doctor shut it down. Following my diagnosis my doctor immediately had me start antivirals. First is intensive rounds every 4 hours for 5 days to control my first outbreak. Then she wants me to take them twice a day for at least a year though I could take them as long as I want as she said there are little to no negative side effects. The only side effects I have read about are some people get headaches, but there are various options of different brands and most people can find one that does not cause headaches. Mine have not caused any side effects at all though as someone else mentioned they can cause dehydration but I drink water constantly so that hasn't been an issue. The way she explained is that the meds will stop future outbreaks while my body builds its own immunities to the H.  Then she wants me to stop and see how my body is doing on its own to see what the future treatment will be. I have also read they are great for providing extra safety for the non-positive people we date in the future so if it is something you would like to look into I would highly suggest it. 

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I recently started suppressive therapy and it has made me feel a lot better about myself- because my obs were pretty frequently; I did it online because I couldn't bring myself to go to the doctors. Haven't been back there since my diagnosis and thinking of going back and getting questioned about it by my primary gives me terrible anxiety. Has anyone felt that way? How was your experience?

I wish every day I could go back and prevent this shit from happening. Especially because I feel my intimate life will never be the same.. The more research I've done about herpes the more I'm mind blown.. I feel like there is such limited education given out on STD's especially to younger people- who need to hear it the most!! 

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On 4/26/2019 at 1:14 AM, Tired of waiting said:

I do not think there are many side effects to a suppressive therapy? so if that is what you want to do then go for it, or a modified one where you take when you plan on being sexually active. I think the drug kicks in within hours of taking it so. my understanding is Valtrax interrupts the replication process of the virus, by denying is resources to create new copies of it self.  Its not like antibiotics where if the full dose is not taken, it results in a weakened bacteria survive to develop a resistance to the drug.

At 21, your world is not over, the will most likely be cure within the next 5-10 years. plenty of time to sort your self out. 

That’s good to know about how the anti-vitals work, one of my biggest concerns was building resistance to the drug so that then if I did have an outbreak the antivirals wouldn’t work, but if that’s not an issue then I can’t see why I shouldn’t go through with it. Thank you for replying!

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On 4/26/2019 at 3:21 AM, IcantThinkofaName said:

my dr was pushing it on me- the suppressive daily therapy due to too many OBs. I was at first just taking during OBs, or perceived OBS when I could catch it in time (I rarely caught it in time to head it off at the pass) I finally agreed to do daily suppressive for year. Now I am afraid to stop taking it...my year will be up in Sept. What were his/her reasons to not give you suppressive therapy?

Its a good idea if you are in sexual relationship with a Non-HSV person...thats for sure.

It makes me dehydrated...drink a lot of water with it. Maybe sinus stuffiness...but that could be from other things too- hard to say. However it affects people differently. I wish I didn't have to take it. I wish I could  go back in time and never have gotten this shit.

They only recommend it if you have more than 6 OB’s a year she said, she actually then said she wouldn’t be licensed to prescribe me the suppressive therapy because I’d only had one OB, but that’s why I confused to find that I could buy it online- very easily, without even telling my GP. Are you in a relationship with a non-hsv person? I drink a lot of water anyway so I don’t think that would be a problem. Same here, hopefully they create a cure soon😞 thank you for replying 

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On 4/26/2019 at 4:19 AM, Theysaylifegoeson said:

I wonder why your doctor shut it down. Following my diagnosis my doctor immediately had me start antivirals. First is intensive rounds every 4 hours for 5 days to control my first outbreak. Then she wants me to take them twice a day for at least a year though I could take them as long as I want as she said there are little to no negative side effects. The only side effects I have read about are some people get headaches, but there are various options of different brands and most people can find one that does not cause headaches. Mine have not caused any side effects at all though as someone else mentioned they can cause dehydration but I drink water constantly so that hasn't been an issue. The way she explained is that the meds will stop future outbreaks while my body builds its own immunities to the H.  Then she wants me to stop and see how my body is doing on its own to see what the future treatment will be. I have also read they are great for providing extra safety for the non-positive people we date in the future so if it is something you would like to look into I would highly suggest it. 

I had the antivirals during my initial outbreak, I went home and did a lot of research, went back and I said I wanted the suppressive therapy and she said no. She said she wouldn’t be licenced to perscribe it to me, which again is confusing because I can get it online. See knowing that would just really help me as at the moment it’s something that I can’t stop thinking about. I’m going to go back and speak to her again as so far I can’t see a reason not to give it a go. Has taking the anti-virals daily made it easier for you to date? Thanks for replying!

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On 4/26/2019 at 4:29 AM, endthestigma said:

I recently started suppressive therapy and it has made me feel a lot better about myself- because my obs were pretty frequently; I did it online because I couldn't bring myself to go to the doctors. Haven't been back there since my diagnosis and thinking of going back and getting questioned about it by my primary gives me terrible anxiety. Has anyone felt that way? How was your experience?

I wish every day I could go back and prevent this shit from happening. Especially because I feel my intimate life will never be the same.. The more research I've done about herpes the more I'm mind blown.. I feel like there is such limited education given out on STD's especially to younger people- who need to hear it the most!! 

Glad to hear it’s made you feel better, whilst I’ve only had one OB I feel it’ll help me in the same way. I feel okay rn speaking to the GP that I saw initially, before I was diagnosed, but I wouldn’t speak to any other GP about the same thing. Just makes me really uncomfortable the more people that see my face and know I have herpes. 

I feel exactly the same way. I was really ignorant about it before, and I was really shocked about how common it is, how easy it is to get, how many people have it and don’t know ect. And the fact that condoms can’t 100% prevent it- this really blew my mind because it’s not something I’d ever heard before. I don’t understand how most of the population don’t have it.  Can I ask how old you are and how old you were when you were diagnosed? Thank you for replying as well 

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10 minutes ago, Aubrey06 said:

Does anyone know how much (or if) suppressive therapy decreases the potential to transmit the virus?

Studies show that it cuts it in half, potentially even more if taken with military precision on timing!

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In half...so like 25% or 1% transmission rate? Sorry - I am so overwhelmed by the articles online I am using you as a mediator (not fair). There is a BJM article that says 40% and another in Science that says 1%...?

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This is an article that the impact of antivirals on shedding. Pretty amazing stuff: https://academic.oup.com/jid/article/190/8/1374/878164

However shedding does not equal infectiousness. Studies of couples showed that about half the proportion using antivirals became infected compared to placebo couples. I suspect in these studies there is a lot of erratic use of antivirals. It seems that studies of couples who studiously observe no sex during outbreaks and regular antiviral use achieve very low transmission rates.

The rule of thumb for healthy couples where infection with HSV-2 is known for one person and more than a year old is as follows:

Male to female: 8%; Female to male 4%.

With antivirals: 4%, 2%

With antivirals and condoms: 2%, 1%

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18 hours ago, WilsoInAus said:

This is an article that the impact of antivirals on shedding. Pretty amazing stuff: https://academic.oup.com/jid/article/190/8/1374/878164

However shedding does not equal infectiousness. Studies of couples showed that about half the proportion using antivirals became infected compared to placebo couples. I suspect in these studies there is a lot of erratic use of antivirals. It seems that studies of couples who studiously observe no sex during outbreaks and regular antiviral use achieve very low transmission rates.

The rule of thumb for healthy couples where infection with HSV-2 is known for one person and more than a year old is as follows:

Male to female: 8%; Female to male 4%.

With antivirals: 4%, 2%

With antivirals and condoms: 2%, 1%

Thanks for those statistics, really helpful :)

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Hi all, does any of you know any useful information or article about the risk of acyclovir resistance in long term suppressive therapy? Thank you in advance 

Edited by Benyamin
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On 5/4/2019 at 10:11 PM, Benyamin said:

Hi all, does any of you know any useful information or article about the risk of acyclovir resistance in long term suppressive therapy? Thank you in advance 

This was something I wanted to find out about as well, not sure whether it’s worth asking a gp about it? 

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  • 2 months later...

I decided not to take those drugs. Every time I do I feel my kidneys straining. And knowing my luck the herpes will become super herpes taking it everyday 

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  • 1 year later...
On 4/29/2019 at 1:46 AM, WilsoInAus said:

This is an article that the impact of antivirals on shedding. Pretty amazing stuff: https://academic.oup.com/jid/article/190/8/1374/878164

However shedding does not equal infectiousness. Studies of couples showed that about half the proportion using antivirals became infected compared to placebo couples. I suspect in these studies there is a lot of erratic use of antivirals. It seems that studies of couples who studiously observe no sex during outbreaks and regular antiviral use achieve very low transmission rates.

The rule of thumb for healthy couples where infection with HSV-2 is known for one person and more than a year old is as follows:

Male to female: 8%; Female to male 4%.

With antivirals: 4%, 2%

With antivirals and condoms: 2%, 1%

Just to make it clear for everybody. Those are transmission rates per year, and not per act, right?

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