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General Medical Questions
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Question : I have genital herpes. I rarely have an outbreak -- maybe once a year or less, but of course I have no idea when an outbreak will happen. Should I be on Valtrex to prevent transmission of the disease?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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April 23, 2012
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A:

When you have very infrequent visible outbreaks of genital herpes like you’re having, there is no right or wrong answer. Here are some facts that can help you decide whether you want to take Valtrex (valacyclovir), acyclovir or famciclovir daily.

Antiviral drugs for herpes stop the virus from multiplying. This decreases the frequency of outbreaks when taken daily. However, the drugs do not cure the infection. When you stop taking the antiviral drug, the virus usually becomes active again.

The Centers for Disease Control and Prevention encourages people with six or more outbreaks per year to consider suppressive therapy. This helps with personal comfort. And it decreases the risk of spreading herpes to a sexual partner. With frequent attacks, viral shedding and the risk of transmission is high, both during and between outbreaks.

For a person with only one or two attacks per year, these outbreaks can be treated intermittently with Valtrex at the first sign of symptoms. However, there is still the risk of spreading herpes between episodes. The amount of viral shedding and the risk of transmission to a partner vary from one person to the next. There is no reliable way to measure viral shedding.

If you have a single sexual partner and he or she has no history of genital herpes, you can expect to decrease the risk of transmitting the virus by taking valacyclovir 500 mg daily. In addition, male condoms should always be used. Also, avoid sexual activity during an outbreak.

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