Is there any prophylaxis or pre-treatment for herpes exposure

December 16, 2011 7:43 PM

Friend was possibly exposed to genital herpes, wonders if there is prophylaxis treatment before any symptoms would appear?

Heard that possibly taking anti-virals may prevent infection. He went to small town doctor and he said "no" but asked me since I apparently know these things and live in the big city. Exposure was 3 nights ago. Female partner never had eruption before, but went to doctor today thinking she may be having 5 or 6th day of outbreak.

posted by anonymous to health & fitness (5 answers total)

I am not a doctor, etc. but I am the 5-year partner of a herpes + individual who is still herpes -.

If friend cannot get ahold of any acyclovir, at least try strong health-foody anti-virals, my favorite is elderberry extract. Get it like, now, and take it like crazy.

Other folk may drop in to disparage my woo, but I say if dropping a few bucks on a food supplement can make a difference and maybe soothe the mind by actively addressing the situation, why not?
posted by Rube R. Nekker at 8:08 PM on December 16, 2011 [1 favorite]

The general medical wisdom has been, not really, but that might not necessarily be the case.

Herpes simplex is transmitted through skin to skin contact when an infected partner gets micro-tears in their skin causing release of the virus into micro-tears in the exposed partner's skin. It is a virus capable of a latent infection, which means it can be there and not cause symptoms of any kind. Asymptomatic transmission is possible, especially in the first 12 months of infection, as the infection establishes itself.

Herpes is not curable because there is currently no meaningful way to address the virus during its latent stage once it has really colonized enough of you. Essentially, the viral genome camps out in a bunch of your cells and shuts of the cells' mechanism for saying their infected to your immune system. While it is in this stage it is indistinguishable from non-infected cells to both your immune system and all known treatments. If your friend has in fact been meaningfully exposed, they would have these latently infected cells and the thinking has been that it is thus likely to late to not have herpes.

What the anti-virals do is act as analogs to nucleotides in DNA that inhibit the viral DNA polymerases that replicate the viral genome in an active infection. There is one anti-viral that has shown some promise in working well enough at reducing latent infections that if used early enough it may reduce your friend's chance of ever developing an outbreak. Famciclovir has been shown to work this way in vivo as well as have efficacy at preventing a first outbreak in mouse models. I would strongly recommend that your friend go to a doctor immediately with those papers in hand and this bulletin to see if they can get an off-label prescription.

Its worth a shot.
posted by Blasdelb at 8:23 PM on December 16, 2011 [3 favorites]

whoops, that link should say in vitro
posted by Blasdelb at 8:28 PM on December 16, 2011

Also infusions of elderberry taken orally have shown efficacy against a bunch of viral infections and appears to possibly have the effect on herpes maybe. If it were me I'd probably figure it worth a shot, I'm about as anti-woo as they come and I've got a tincture of elderberry suspended in vodka that I now take shots from, with lots of water before and after, whenever I get viral stuff.

Please also make sure your friend knows that this is now a meaningful part of their sexual history that aught to be shared with new partners even if they don't ever get symptoms for a long time.
posted by Blasdelb at 8:35 PM on December 16, 2011 [1 favorite]

Please also make sure your friend knows that this is now a meaningful part of their sexual history that aught to be shared with new partners even if they don't ever get symptoms for a long time.

Give. Me. A. Break.

Not to go too far afield here, but OP, you can tell your friend that there is a blood test for Herpes that is very accurate after eight weeks post-transmission. If that test is negative eight weeks from now, no, he does not have to disclose this experience to his partners. However, he might test positive even if he didn't contract anything during this encounter because, well, read on...

Keep in mind is that most adults are carriers (if not symptomatic) of the Herpes virus. If your friend has ever had a cold sore, or if he's ever made out with someone who had an active one, it's likely that he's a carrier of HSV-1. Yes, HSV-1 and HSV-2 are different viruses, but your odds of contracting the other after exposure are drastically reduced if you already have one. Furthermore, HSV-1 infections of the genitals are SUPER common now (even though 1 is traditionally considered "oral herpes" -- figure that one out), and contracting the same virus in a different part of the body (e.g. HSV-1 on your mouth and on your genitals) is also extremely uncommon.
posted by telegraph at 8:47 PM on December 16, 2011 [8 favorites]