[Question #10211] HSV-2 Transmission

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24 months ago
Hi there,
Hoping to get a couple of 'realistic' answers bc the web is so wishy-washy. I'm a 42, HSV-2 positive male. Diagnosed 13 years ago, asymptomatic. My partner is 30, HSV-1 positive female. Both our infections are in the expected places (genitals/mouth). 

1. What are the chances of HSV-2 transmission to her per encounter of unprotected intercourse, assuming no lesions are present? What would Valaciclovir reduce this to?

2. What are the chances of HSV-2 transmission to her mouth and/or lips if she gives me fellatio? Ie, I know it's possible, but is it like I could get struck by lightning in a storm possible or more than that?

Thanks in advance! 
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Terri Warren, RN, Nurse Practitioner
24 months ago
we do not have data about per encounter transmission for HSV 2.  We do know that the average transmission rate from  male to females, having sex about twice per week when no lesions are present and no condoms are used and no antiviral medicine is taken, in established couples, is about 10% per year - that is about 10 women will get infected per year.  That is in couples who've been together for a while and transmission has not occurred. It is likely higher in new couples who have sex more often.  When antiviral medicine is taken daily, it reduces transmission by 48%. Condoms reduce transmission by 96%. We do not have data on HSV transmission to the mouth during oral sex but we do know that HSV-2 does not like the oral area much at all. I wish I could give you more statistics about that but we just don't have them. We know that it happens but we believe it to be uncommon.
Terri
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24 months ago
Thanks for the reply!

Two follow-ups:

1. Possible to tell me how much/many cases of HSV-2 being transmitted orally you’ve personally seen in your experience?

2. I’m in the UK and I’d like to start medication to help protect my partner but I suspect they’ll prescribe me Aciclovir. Is that effectively as good as Valaciclovir as an antiviral?

Thanks!
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Terri Warren, RN, Nurse Practitioner
24 months ago
How many? Perhaps 10
Acyclovir is as good as Valacyclovir though it must be taken twice a day instead of once a day.

Terri
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