male, 50's, hsv-2 for two decades ( acquired fm 2nd sexual partner).
I was married to 3rd partner and intimate for 14 years without transmission (she was aware and unconcerned). We abstained when I had an outbreak and I took acyclovir during them.
I took valacyclovir 500mg daily for most of 2+ years with my last partner who also did not acquire hsv2 (also informed and medically counseled).
At this point I go years between outbreaks and usually can relate them to trauma or severe stress.
My potential partner:
female, 50's, History of breast cancer approximately 1 year ago. She had a masectomy, and is taking tamoxifen.
She is not hsv2 seropositive to her knowledge.
She is concerned regarding the immunological effects of Tamoxifen vis a vis the increased risk of contagion, and the increased complications of managing HSV while on tamoxifen.
Tamoxifen appears to have differing effects on humoral and cell mediated immunity. How will this affect her risk.
Please advise regarding, options, risk of transmission, potential outcomes, etc
Welcome to our Forum. There are no studies or scientific data to guide my answers to your question. As you are aware, tamoxifen has been shown to help treat breast cancer and that it does appear to have effects on the immune function of persons taking the drug. Despite this, there is no way to logically tell you whether or not your potential partner's risk for getting herpes is increased because fo the drug or not. Having acknowledged this, let me make several comments:
1. The risk of transmission of infection is rather low. The longer a person has ha HSV, the less likely transmission is to occur. Your past history tends to bear this out.
2. Depending on her/your level of concern, you can reduce what risk there is through condom use, taking preventative antiviral therapy with acyclovir or valacyclovir or both measures (i.e. condoms and suppressive therapy) will significantly reduce this risk of transmission of infection.
3. The fact is that there is a chance your partner already has HSV-2. Please remember that 20% of adults have HSV-2 an of these, about 90% do not know they have it. Based on this, I would suggest that it might be worthwhile for her to be tested with a type-specific gG-2 based IgG assay for HSV antibodies such as the HerpeSelect. If her test is positive, there is no risk of further infection for her.
I hope these comments provide some guidance and are helpful. EWH
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