I was just diagnosed with genital HSV1 (culture and blood test came back HSV1) and I’ve probably had it since Fall 2008 when I had a PAP show cells that looked like herpes. I had what was probably an OB October 2008 and then nothing until August 2011 and then again a week ago (when I had the +culture).

I’ve got a few questions:

What would make it be so much more active all of a sudden? The August OB was about 4 days after having sex with a new partner. And I seem to have some irritation after sex with him pretty regularly – how do you know what’s an OB and what’s just irritation? My OB that was cultured didn’t have any sores – just painful when touched and swollen and they’ve all only lasted 2-3 days.

My PA had me start taking Acyclovir (400mg 3x/day for 10 days). How do you know when the OB is over and it’s ok to have sexual contact again? The PA said it should have cleared by now (day 9 of medication) but I’m having clitoral irritation after sex again (no symptoms for the last few days… and I’ve been a bit paranoid/emotional over the whole thing).

I’ve seen % for HSV2 transmission with/without condoms/suppressive therapy… is there data for HSV1 as well?

What are the side effects for suppressive therapy? I have a friend who’s done it for about 10 years and now has elevated liver enzymes.


And a mini rant -- I’m a sexual health provider working towards becoming a PA and I’m so annoyed my peers’ lack of knowledge/acceptance around herpes. (Not to mention the identity crisis that strikes me every time something like this comes up – I have high risk HPV too, viruses apparently love me). The person who delivered my culture result said “it’s positive for HSV1 – which causes cold sores… not HSV2 which is genital herpes. So, you know have to worry about that”. Nevermind it was a GENITAL culture. Sigh. It’s getting really hard being the one person who knows personally what it’s like… and feeling obligated to share my story, ya know?

welcome to the forum!

Since this is just a recurrence for you and not a newly acquired infection, you only need to take acyclovir 400mg 3x/day for 5 days or 800mg 3x/day for 2 days - both speed healing at the same rate. the 10 day dose is just for newly acquired infections. too late since it's already day 9 of symptoms but just a fyi for the future.

did they also by chance test you for yeast and bacterial infections vaginally when you were seen too?

preaching to the choir about folks who should know about herpes and don't here I work in a major teaching hospital and have to do far too much teaching of my peers about herpes. Even had to correct a speaker at a conference on adolescents and std's a few years ago. it annoys the heck out of me!!

daily suppressive therapy has no long term side effects. Odds are your friend who's been on suppressive therapy for 10 years, has elevated liver enzymes from something else and not the acyclovir. we have info on over 25 years of non-stop suppressive therapy and we don't even recommend testing routinely because of being on suppressive therapy.

as for hsv1 genital transmission risks, it doesn't happen very often so we don't have the same stats for it like we do for hsv2. has your partner been tested yet for herpes to know their own status? what about other std's?

betsy

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ASHA Moderator