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HSV2 with recurrent outbreaks on VALTREX. Treament.

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My 65 year-old friend was diagnosed with HSV 2 approximately 7 months ago. From both personal research and the response from my Dermatologist the typical outbreaks vary, but when taking 1000 mg. up to 3000 mg. of Valtrex daily she has had near continuous burning, redness, pain in her groin area. (I have spoken to two ladies who have had HSV 2 for about ten years. However, both reported about 1 or 2 outbreaks or fewer per year.) My friend had 3 weeks of relief within this 7 month period after taking 3000 mg. of Valtrex per day for a couple of weeks. Her physician then put her back on 1000 mg. and within a couple of days she experienced another outbreak which has been continuous.

Question: She has some type of auto-immune issue related to her thyroid. Otherwise, she is healthy and lives a healthy lifestyle. Can you offer recommendations as to why her symptoms have been nearly continuous for 7 months with the exception of the 3 weeks? And is there any other recourse she has or a physician who specializes in such extensive, acute cases of HSV 2?

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: Cosmetic and Plastic Surgeon
 25 Doctors Online

Thank you for your query at
The problem with herpes outbreaks is that no one can really predict the number of outbreaks per year. However patients on Valtrex ( Valacyclovir ) have fewer than 3-4 outbreaks per year. Such outbreaks also depend on the current nutritional or the stress the individual has, as stress or low immunity seems to make it more frequent.
How is her health overall? Does she have any diabetes/hypertension? Diabetes makes a patient more prone for recurrent infections.
There is no such specialisation on herpes because most herpes cases are handled by internal medicine specialists or the dermatologists.
In this situation we need to assess her overall health. So can you provide me a detailed medical history?

Patient replied :

Thank you for your response. My friend is generally in good health. She does smoke some. Only some low evel of hypertension. She does have a thyroid-related auto immunce disorder. However, she has no major healthy conditions or lifestyle issues which seem to be sufficiently serious enought to cause such lengthy continuous symtoms. Thank you.

The fact that she has thyroid related auto immune disorder shows that her immune system is slightly over active compared to other cases.
So whatever trivial herpes virus proliferation is there in the site, due to the immunity she will manifest the rash.
The rash or the sores are all body's way of fighting off or warding off the infection.
This could be one of the possibilities.
For example, for a lot of people in US ( almost 1/3 rd ) they have HSV-1 infection but they never manifested. That is because of good immunity. However if the immune system starts reacting to even one or two isolated viruses, then it will actually be detrimental. It is like acting against the normal flora.
So i guess in her case she has a predisposition for auto immunity. And hence she needs such high dose to maintain absolutely zero levels of HSV-2 viruses, the moment even a few multiplies, she gets the rash or sores.

Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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