I have Herpes Labialis

Dear Dr. Tom:

I have Herpes Labialis, or, of the mouth. It usually manifests about two to three times a year, during periods of high stress and low rest. I am taking 800 mg of Acylclovir 4 times a day, and for the past five days, it doesn’t seem to have done much on the sore I currently have. Usually, it is effective much faster. Is it possible that the virus is building up an immunity, such that I would need another treatment? Also, I got this from my girlfriend. She had the virus in the form of a small cold sore, and I got it from an open wound in my mouth, due to mouth-to-mouth contact. When I have a sore with a white covering, signifying that I am contagious, does she have to worry about contracting the virus, maybe a worse type or as a different type of virus, even though she’s the one I got it from?? Is she at risk?
Thanks, Distressed

Dr. Tom’s Response:

Dear Distressed:

Yours sounds like what is referred to as a "ping-pong" infection. Only in ping-pongs, one partner is cured, while the other partner re-infects him/her. Microorganisms, including viruses do not become immune. They can become resistant to a variety of anti-microbial substances used to treat the infections they cause. Some of the following facts may help your thinking, hopefully without confusing you: Isolation of acyclovir resistant mutants of HSV isolates was reported in 1980. These were laboratory studies. Virus which is less sensitive to acyclovir possibly may result within those persons taking that drug. Such patients are advised to take precautions they do not transmit the virus if they experience active sores while they are taking the drug. Acyclovir is not equally effective in all persons. A quantative relationship between laboratory susceptibility of HSV to acyclovir and its clinical effectiveness in humans has not been established. If the two of you have not participated sexually with any others, the likelihood of another virus strain in the scenario is nil. See your health care provider who put you on acyclovir in order to discuss the way your treatment has gone.


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