#1 - No, you will always test positive. If you've read something that says people taking antivirals can test negative, I'd love to read it.
#2 - If you are otherwise healthy, it probably won't be an issue for you. I've been on antivirals for almost 20 years and have no issues. All of my blood work in my yearly check ups is normal.
#3 - You do shed more around outbreaks, but can shed without having an outbreak. Taking daily antivirals can reduce this, but it doesn't eliminate it. People without outbreaks do still shed.
Thank you for the response and the detailed statistics. I have never had an outbreak in my genital. And I have tested twice (6 months in between) and both times I am positive for HSV-1 and not HSV-2. First time HSV-1 IgG = 51.9. Second time HSV-1 IgG = 41. I know the basics about HSV and I appreciate you taking your time to explain it.
1. I was not expecting acyclovir to reduced the antibody response, I don't even think that's how that works? Acyclovir is an antiviral drug. It doesn't kill all of the virus but enough for people to use it to prevent outbreaks. That's what I know. And the reduced antibodies is a consequence of a reduced virus presence in the body. That's why some people can see a "negative HSV-1 result", basically IgG lower than 0.9 due to reduced HSV-1 presence in the body from taking acyclovir daily for a consistently long time. I personally have never experienced an outbreak actually. I am just interested to know if people can still take it daily just to prevent it from spreading while kissing, oral sex etc. That's what I am interested in knowing. I would like to continue doing those things without worrying if I am going to spread it, without having to ask if they have HSV every time. (Based on the assumption that if I get the HSV-1 presence in the body so low that IgG comes back below 0.9, and assuming that it means reduced risks of me spreading HSV-1 year round dramatically or closed to 0)
2. Thanks for reminding the possible issues with liver and kidney. I would probably look into some researches.
3. There is a lot of interesting data here. I am more interested in the HSV-1 shredding period. I am assuming those days are probably closed to days when a person experience an outbreak? What about people who never experienced an outbreak? I am assuming that the shredding still happens even without outbreaks?
If you've never had genital symptoms, you can pretty safely assume that you have an oral hsv1 infection. About half the adult population in the US does, about 2/3 globally.
1. Does that work and is that recommended, if not, why?
No. First, when you test with the IgG, you are testing for antibodies, not the actual virus. Even if you reduced the antibody response with the medications, you don't cure the virus.
Taking Valtrex or acyclovir helps prevent outbreaks and reduces transmission, but it is not a cure.
2. Following the above question, are there any known research about the effects of people who take those treatment every day consistently? Any known side effects?
For otherwise healthy people, the meds are considered safe for long term use. There can be side effects in people with kidney problems and maybe liver problems, but you can address that with your doctor. Sometimes a dose adjustment works, other times you need to avoid the medication.
2. If i started taking acyclovir or valacyclovir every day consistently and got a negative result eventually, what are the risks of me spreading HSV-1 to others through kissing, oral sex, sharing utensil, etc?
We don't have transmission stats for hsv1, unfortunately. We do know that suppression reduces transmission by about 48% for hsv2, and it's assumed that it should work the same for hsv1. (Of course, if we don't know transmission rates, what does 48% mean, right?)
**Most importantly, before I get into the rest of this - if your partner has hsv1, you can't transmit it to them. They have antibodies that protect them from getting it again.
Sharing utensils and drinks isn't a really effective way to transmit it, but in the age of covid, it's not a great thing to do anyway.
We know that 50% of all new genital herpes infections are genital hsv1 infections. We don't know if this is a better awareness of needing to type test ghsv infections, more oral sex, or both (probably both, in my opinion).
Kissing is a very common way of transmitting it.
The chances of transmitting it without an outbreak present are lower than if one is present.
We know that hsv1 orally sheds about 25% of days per year, which is about 91 days, give or take. A shedding episode may last a few hours, or several. It varies.
HSV 2 genital 15-30% (55-110) of days evaluated
HSV 1 genital 3-5% (10-18) of days evaluated
HSV 1 oral 25% (91) of days evaluated
HSV 2 oral 1% (~4) of days evaluated
I wish I had more specific info to give you. Remember that a lot of people already have this. You are not a walking toxin or biohazard.