I am male, and negative for both HSV1 and HSV2

My partner is female, and positive for HSV2 genital, and negative for HSV1. She is asymptomatic. Test are current

We are exclusive and do not have other sexual partners

We have only recently initiated our first sexual intercourse

We live apart and plan to meet to have sex every 3 to 6 weeks

As precaution of against transmission, we diligently use condoms for sexual intercourse and she is planning on going on an antiviral suppressant (Valacyclovir or Acyclovir)

 

My questions are related to antiviral suppression:

1)    Since we are not engaging in sex on a regular basis – and only on specific, prearranged “dates” – does she have to take a daily dose of Valacyclovir/Acyclovir every day of the year to be effective? Or only in a window around when we plan to have sexual contact? And, if a window is possible, what are the perameters for dosage (how many days before/after)?

2)    Is there any known difference between Valacyclovir and Acyclovir in terms of effectively suppressing “shedding” or outbreaks? Or brand-name vs. generics?

3)    Are there any known negative health effects from long-term usage of Valacyclovir/Acyclovir?

4)    Does Valacyclovir/Acyclovir become less effective over time (like how the body can develop a resistance to antibiotics)?

1.  She can start her daily antiviral therapy 5 days before you plan to get together and it will be fully effective. 
2.  Both drugs, when taken as directed, are equally as effective.  Valacyclovir must be taken once a day and acyclovir twice a day.  Generic and branded drugs work equally well when taken as directed.
3.  None at all that we know of
4.  No, there is no evidence at all for that.  There is as much resistance noted in people who have not taken drug as those who have taken drug, suggesting that resistance (very very low rates - 0.3%)  has nothing to do with taking medication

Terri

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Many thanks for your quick reply, Terri! Much appreciated. So, given all of the above, I have one more item regarding unprotected oral sex:

1)    What are the risks/are there any risks of transmission from her (HSV2 genital positive) performing unprotected oral sex on me (HSV2 negative) ?

2)    What are the risks/are there any risks of transmission to me (HSV2 negative) performing unprotected oral sex on her (HSV2 genital positive)?

1.  Assuming she has only genital infection, the risk of her giving you oral sex is zero
2.  We don't have an answer for that one.  I would say it is very low as HSV 2 doesn't like the oral area.  Likely around 1% if she is on daily antiviral therapy - and that's a guess.

Terri
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