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can i transmit the HIV virus with unprotected sex?
Aug 4, 2007

Dear Doctor,

Thanks for taking the time to answer.

I just need one more clarification. If I am HIV positive and because I took Valtrex couple of years back for fifteen days, does this mean that I won't transfer the HIV virus to my partner if I have unprotected sex? Since valtrex reduces the HIV viral load, according to the new study?

This was the question you answered to me, day before yesterday. Here is an update from

http://www.thebody.com/updates/2007-03-01.html

Herpes Treatment Can Control Herpes and HIV Viral Load, Study Finds Treatment with the herpes drug Valtrex (valacyclovir) not only reduces the viral load of herpes simplex virus type 2 (HSV-2), but also reduces HIV viral load in women coinfected with HIV and HSV-2, according to new study results. Although its HIV-fighting ability was modest, the suppressive effects of Valtrex on HIV viral load appeared to increase with time, and were enough to suggest the drug may help slow HIV disease progression. However, more studies are needed to confirm these results. (Web highlight from aidsmap.com)

My situation here is that I had an exposure in 2001, and was identified as HSV2 positive and the doctor gave me Valtrex for 15 days at that time. After that I never used Valtrex.

My question is that based upon the new research which states that "Treatment with the herpes drug Valtrex (valacyclovir) not only reduces the viral load of herpes simplex virus type 2 (HSV-2), but also reduces HIV viral load in women coinfected with HIV and HSV-2, according to new study results. Although its HIV-fighting ability was modest, the suppressive effects of Valtrex on HIV viral load appeared to increase with time, and were enough to suggest the drug may help slow HIV disease progression."

Does this mean that even a PCR test would not identify the HIV virus if I have any, because the viral load is decreased because I took valtrex 6 years back? and does this also mean that I cannot transfer the HIV virus to anyone, because my HIV viral load is low according to the new study.

I cannot get an antibody test because I was on high dose of immunosuppressant for a long period of time, for a kidney transplant.

I have to take a PCR test, it had been long time after a exposure and am worried that I may get HIV.

Response from Dr. Conway

You are right to say that some people who are severely immunosuppressed (as you may be) can have a false negative HIV antibody test. In that setting, the best test to determine infection becomes a PCR test, or some other antigen detection assay. The use of Valtrex in the past or on an ongoing basis will not affect the reliability of the test in any way. The effect of Valtrex on HIV is actually quite modest and indirect, such that it would not really affect the ability of an individual to transmit the virus unless they were also infected with HSV. In that case, it can have an important effect by reducing herpes outbreaks, which can serve as a portal for the transmission of HIV.

Response from Dr. Conway

The Valtrex you took a couple of years ago will have absolutely no effect on the transmission of HIV at this point in time. One does not relate to the other as the effect of the Valtrex on the amount of HIV in the body only lasts for as long as they are taking the Valtrex.



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