[Question #7004] HSv2

10 months ago
I have had confirmed HSV2 for 40 years. I am currently 70 years old. Over the last year or less I have had increasing numbers of recurrences although I have had a lifetime of recurrences.  I use Valocyclovir  as suppressive therapy a lot of the time. Usually 500 once or twice a day works. Before that I used Acyclovir, starting when it first came out on the market.  I very rarely get a lesion, just the nerve pain that signals the onset. Currently I have had this prodromal nerve pain  in my left buttock for three weeks. This is often the place where I feel it first.  My doctor told me it was all right to double the dose to 1000 mg twice a day. Despite this, the nerve pain came back within a couple of days. I even felt like I was going to get a lesion.  I am worried there is something serious wrong with me like underlying g disease causing this constant recurrence. Also, this is terrible for my sex life.  The high dose of valaciclovir also makes me feel somewhat unwell.  I am very active physically including running, Pilates and gardening.  I am outside most of the day but wear a hat, sunscreen etc.  The only thing that has changed in the last month is that I started an online pilates program. And have not done Pilates before.  I have not been sleeping well.  My bloodwork 3 months ago was normal except slightly high hematocrit and hemoglobin and mch which was probably due to being at altitude for skiing. 

Would you give me your insights on what could be going on and what I might do to deal with this?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
If doubling the dose of antiviral medicine doesn't help with the symptoms and they last for three weeks, I would suspect this might be something other than herpes that is causing the nerve pain.  It is likely not a coincidence that you started a new exercise program and have this pain, but that's just an educated guess.  You seem to be very familiar with your body and the signs an outbreak is coming.  I just wonder if this time, you are correct.  If you are going to be on suppression, be on suppression regularly, taking your medication at the same time every day.  You can very safely take 500 mg of valtrex twice a day for an extended period of time.  Please let me know what other questions you have.