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Herpes misconceptions

May 20, 2008 - 3 comments

suppressive therapy






discordant relationships



There are soooooooooo many myths and misconceptions out there about herpes and treatments.  If you haven't read the herpes handbook yet at please give it a read. It's a terrific resource to learn more about herpes ( and the website also has info on other std's too ). Also  is another valuable resource to learn more at about herpes and other std's.

so the myth I'd like to address in this entry is - suppressive therapy is only for folks who have a lot of ob's.

WRONG! There is no magic number of ob's you have to have before suppressive therapy is appropriate for you.  How you treat your herpes is a personal choice so do your reading and decide for yourself ( and with your partner if you have one ) how you want to treat your herpes.  If you are in a discordant relationship ( one partner has hsv2 and the other partner doesn't ) then suppressive therapy might be the right choice for you even if you can't recall ever having a single genital lesion.  Daily suppressive therapy with valtrex has been shown to reduce the chances of transmitting hsv2 to a partner by 48% ( NEJM jan 1, 2004 ).  It can be a valuable tool for protecting a partner.

Even if you and your partner both have hsv2 - if you are having either frequent ob's or just the ones you do have really inconvenience you you can still go on suppressive therapy.  No reason to suffer thru ob's if you don't want to.  The long term safety of suppressive therapy has been well established so you can stay on suppressive therapy as long as you need to ( JID 186 suppl 1, 2002 ).  It's totally your choice. No risk of kidney or liver damage if you are otherwise healthy. It's definitely worth talking to your provider about if you are interested in.

Do you have to stay on suppressive therapy FOREVER if you chose to treat your herpes that way? No you do not. You might find yourself going on and off suppressive therapy as the situation calls for it in your lifetime of living with genital herpes.  Perhaps you feel more comfortable being on it in a new relationship until you both feel more confident about being together.  Perhaps you find that as you get older you get more ob's so you want to be on it or perhaps even as you get older you decide to stop it because you are just sick of taking medication or you want to see how many ob's you get .  Perhaps you were in a relationship with someone who was hsv2- originally so you chose suppressive therapy but then your partner contracts hsv2 from you or you enter into another relationship with a hsv2+ partner.  You can go on and off it as the situation calls for it. Just remember that if you are going to bother to chose suppressive therapy - you need to be taking your medication as directed reguarly in order for it to work!  

Feel free to talk about your experiences with suppressive therapy or ask any questions you might have about it either here on the journal or on the herpes community forum :)


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by Emma_08, May 20, 2008
Just a quick question about suppressive therapy - if you start taking it, then stop - is there any chance that the virus can build up resistance to the medication (like with HIV antiretrovirals)??

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by gracefromHHP, May 20, 2008
thankfully no :)  Even after 25+ years of acyclovir use - the rate of resistance is still ~ 1% for otherwise healthy folks and 5% for immunosuppressed folks.  


Avatar universal
by anne_bluebell, Oct 04, 2008
hi grace; late to the party... if someone were to take it on an 'as needed' basis: like one a week or twice a week, when they were going to be with someone, would that be just as helpful for prevention? would it have any effects on the person taking it that might weigh against the benefits for the partner without herpes?

any thoughts on acyclovir vs. famciclovir?

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