[Question #10641] HSV1 transmission

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21 months ago
Being HSV1 positive but have not had any breakouts in atleast 2 years and taking 500 mg of Valcyclovir every day how likely are you to transmit the infection to your partner during oral sex Femaile to Male. I understand that viral shedding without any breakouts or symptoms happens 10% during a year; so never knowing when that is happening do I need to assume that I am contagious everyday and all the time? 
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Terri Warren, RN, Nurse Practitioner
21 months ago
Are you saying that you have HSV 1 genital infection?  If yes, then the statistics about shedding and transmission are NOT the same as HSV 2, which I think you are quoting.  
Once someone has been infected with genital HSV 1 for two years, they shed virus, on average, 4 days out of an entire year.  So clearly, you are not contagious everyday and all the time.  The problem is you cannot know when you are shedding because it can happen when you do and when you don't have symptoms.  About half the population already has HSV 1 infection, most orally, so that's another reason that transmission through intercourse is so rare.  Does this help?

Terri
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21 months ago
I have Oral HSV1 not genital. So my questions was specific to oral herpes and transmission of HSV1 during oral sex to my partners genitals. Fenmale to Male. What are the statistics regarding possible transmission if I have not had any break outs in over 2 years and I am taking 500 mg. of valcyclovir daily. Thanks

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Terri Warren, RN, Nurse Practitioner
21 months ago
OK.  HSV 1 oral infection is more likely to shed virus but we don't have an exact number for that.  But taking daily Valtrex will certainly reduce viral shedding and thus reduce transmission. It isn't perfect but very effective.

Terri
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21 months ago
When the virus sheds is it in my saliva? and if I never know when I am shedding am I potentially always putting my partner at risk whether I am kissing him or giving oral sex? 
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Terri Warren, RN, Nurse Practitioner
21 months ago
It can be in saliva, yes.  Do you actually know that your partner is HSV 1 negative?  If they have been tested by IgG and it is negative, the IgG test misses 30% of HSV 1 infections compared to the western blot.  Is your partner concerned about this or is it more you that are concerned? About half the US population under the age of 49 has HSV 1 infection so very common indeed.  It is probably worth having a very frank discussion with your partner about if they would want to discontinue kissing and receiving oral sex from you for the smallish risk of getting HSV 1 from you.  Your daily suppressive therapy will reduce this risk as will symptom awareness on your part.  I already have oral HSV 1, but if I didn't,  would I give up kissing my husband (who also has HSV 1) or receiving oral sex from him for fear of getting HSV 1 from him?  Heavens no!  But these are individual decisions that you and your partner must make together.

Terri
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