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Antiviral Meds Question

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i was recently diagnosed with hsv2 ... with my outbreak I only had two open cuts and swollen lymph nodes .. I already had ghsv1 . I want to do suppressive therapy but I have a few questions..


1) what’s the difference in acyclovir and Valacyclovir? 

2) do meds stop outbreaks from happening if you take them everyday ? 

3) should I jump right on the suppressive therapy boat or should I see how frequent my outbreaks are first ?

4) was my outbreak mild because I already have ghsv1? 

5) what’s my transmission rate if I decide suppressive therapy 

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1. Valacyclovir is converted to acyclovir by the liver, and once this happens, it prevents herpes in the same way as acyclovir. Valacyclovir has a higher level of bioavailability, so a lower dose is needed to get the same effects (eg, 500 mg valacyclovir is similar to 800 mg of acyclovir). 

2. Meds stop or reduce the frequency of outbreaks if taken every day. Often if people do get outbreaks on suppressive (daily) therapy, they are less severe. 

3. It's up to you. If your first outbreak was mild/tolerable, you may want to see how your body handles it, but this is an entirely personal decision and there is no right or wrong answer. 

4. Probably. It is documented that people with prior HSV-1 infections have less severe outbreaks with subsequent HSV-2 infections. 

5. There is no exact science to figure this out, but generally antivirals reduce your risk of transmission about 50%. The stats on this site (which are compiled from several reputable resources) are that female to male transmission for HSV-2 without antivirals and without condoms in a given year (when avoiding sex/contact during outbreaks and any prodrome symptoms) is about 4%. So antivirals would likely reduce this risk to about 2%. Male to female transmission risk is about 10% in a year without protection, and 5% with antivirals.

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