Common Herpes Simplex outbreaks, what else can I do

Hello Dear Terry,

I am 24, female and about 5 years ago I tested positive on HSV-1 (I don't how the test was called exactely) and since that time I really have severe problems with herpes outbreaks on my lip. Apart from herpes my immune system works quite well, I don't know what the problem is!
At the beginning it occured once in two month then it got worse and worse, twice a month in combination with the tiniest activators like menstruation, stress, unhealthy food or even one little spot near my mouth. During that time I got really depressed and didn't want to go to Universitiy anymore. I did not just look weird it really hurt, too! Nothing helped, i tried it with an Acyclovir supression therapy for 3 months but as soon as I stopped it, it continued being that worse.
Then in the last 1,5 year I just had 1 single outbreak and I felt comfortable that it would get better now. But in October 2011 I got again 2 very outbreaks and after I found out that my boyfriend had several affairs in our relationship I broke up and you can imagine that it got worse again.
Since October I am under supression with Acyclovir again. Now my doctor tols me to end the supression.
I am very terryfied that it will get that worse again! What else can I do against outbreaks? Is the only possibility being in antiviral drugs for the rest of my life? If yes, are there any long-term side effects?
My doctor doesn't take this problem seriously because "People don't die from herpes". Bur I really want my "normal" life without herpes back!
12 weeks after my last realtionship (because of his affairs) I tested HIV negativ - so this can not be the trigger. The docors in the HIV forum told me that acyclovir does not inhibit the HI virus so that I can trust in my negativ result although being ón acyclovir. Would you agree?

I hope my question is not too long. But I really think that you will take my problems seriously as you did it with all the other Users!

[Terri Warren, RN, Adult Nurse Practitioner]

Acyclovir would not interfere with accuracy of you HIV test.  Don't worry about that.

In terms of your frequent cold sores - there is absolutely no reason that you should not continue your suppressive therapy.  Your doctor is out of date on this one.  If he refuses to continue your suppressive therapy you can do one of two things:

1) find another doctor who is more to date on the use of suppressive therapy.
2) print out an article by Steve Tyring on the long term safety of acyclovir and see if your doctor will change his mind.  I am attaching the entire abstract if it will fit, along with the reference, so you can go find it and print out the whole thing for him.  Good luck.

J Infect Dis. 2002 Oct 15;186 Suppl 1:S40-6.
Valacyclovir for herpes simplex virus infection: long-term safety and sustained efficacy after 20 years' experience with acyclovir.
Tyring SK, Baker D, Snowden W.
Source

University of Texas Medical Branch, Galveston, Texas 77555, USA. ***@****
Abstract

An extensive clinical trial program combined with 5 years' postmarketing experience with valacyclovir provides evidence of favorable safety and efficacy in herpes simplex virus (HSV) management. Valacyclovir enhances acyclovir bioavailability compared with orally administered acyclovir. Long-term use of acyclovir for up to 10 years for HSV suppression is effective and well tolerated. Acyclovir is also approved for use in children, is available in some countries over the counter in cream formulation for herpes labialis, and has been monitored in over 1000 pregnancies. Safety monitoring data from clinical trials of valacyclovir, involving over 3000 immunocompetent and immunocompromised persons receiving long-term therapy for HSV suppression, were analyzed. Safety profiles of valacyclovir (</=1000 mg/day), acyclovir (800 mg/day), and placebo were similar. Extensive sensitivity monitoring of HSV isolates confirmed a very low rate of acyclovir resistance among immunocompetent subjects (<0.5%). The incidence of resistance among immunocompromised patients remains low at about 5%.

There you go!

terri

[miley23]

I am from Germany, I am sorry if there are too many mistakes in my Question! Thank you again!

[miley23]

Dear Terri Warren,
thank you very much! Your post was very helpful. I'll print the article immediatly and tell it to my doctor. The fact that it's even used in pregnancy is very interesting. Because I've asked myself often how this could be possible for me because I am not able to stop birth control pill. Every time I tried, my herpes got relly aggresive (aggressive)!
Do you now if there is any chance to get the full text? The article would be enough but this sounds really unteresting to me!

[Terri Warren, RN, Adult Nurse Practitioner]

Most OB GYN providers don't use suppression all during pregnancy, but some do.  

you can get the full text at PubMed on the internet, it is a free article and you can get the entire thing there.
Terri