[Question #1234] HSV-2

50 months ago
I am a female and have tested positive for  HSV 2 IGG Type Specific AB Test and negative for HSV 1 IGG Type Specific AB. 

To the best of my knowledge My HSV 2 has been asymptotic with no initial outbreak.  A previous partner was unfaithful and had the specific blood test done for piece of mind.  I've known for a year and immediately began Valacyclovir for suppressive therapy for 2 reasons 1) to prevent potential breakouts and 2) reduce potential transmission to any future partners via viral shedding.  The net of my research is if you do not have sex during an active outbreak, use suppressive antiviral therapy, and condoms, it's a 2% chance per year a infected female will transmit HSV-2 to a non infected male. 

My current partner has been kind and empathic but doesn't know a lot about HSV-2 and want to help answer his questions. 

 Do you have any statistics on transmition rates for discordant coupons in terms of # of transmissions per # of sexual encounters? No sex via outbreaks and use of meds is a given but what is the difference in risk with or without the use of condoms? To him 2% per year seems extremely low but is looking for additional data that supports that statistic.
 
Also, what is the risk of him getting HSV-2 from performing oral sex on me? 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
First of all, do you know the index value of your HSV 2 positive test?  It's a number associated with the positive result.  If the number falls between 1.1 and 3.5 and you've not had outbreaks, you should consider a confirmatory test.  Also remember that outbreaks can happen anywhere between waist and mid-thigh and buttocks - basically the boxer shorts area.
Actually, your number is close!  If you have sex about twice per week, use condoms and take daily antiviral therapy and your partner knows you have herpes (which he does) the risk is even a little lower - 1-2% per year.    That is, if there were 100  couples in your exact situation, one or two of the males would acquire herpes in a year.  It is important that you take your medicine every day around the same time each day and avoid sex with outbreaks or prodrome. 

We don't have data about oral sex, but since HSV 2 doesn't like the mouth area very much it might be even lower. 

So you can tell you partner that you're right and really up on herpes information!

Terri
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50 months ago
Yes, on the lab report it is listed as "Out of Range > 5.0".  I do take my medication daily at the same time. 

I realize that an outbreak can be mistaken for other common skin irritations and very well could have very mild symptoms that l didn't recognize as herpes.

The fact that it can be anywhere in the "boxer short" area is why I asked about the difference in risk of transmission rates with or without a condom.  If you take condoms out of the equation what does the 1-2% or 1 to 2 people out of 100 with the same circumstances increase to for transmission?


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
OK, so >5 is pretty definitive.  If you take condoms out of the equation, it's about 2%.  It's four percent approximately without condoms or meds, meds reduce transmission by half and condoms by probably another  30-50%. 

Terri
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