[Question #13162] Genital HSV-1 immunocompromised transfer risk
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1 months ago
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I'm a 26M on immunosuppressants (Humira, Mycophenolate for uveitis) and recently started seeing a 25F who has genital HSV-1. She was diagnosed 4 years ago, had outbreaks in year 1, but none for 2 years. She takes 500mg valacyclovir daily. My doctor referred me to a pharmacist, who said I'm at increased risk and pointed me to the CDC site, which made the risk seem high. However, many expert replies in forums suggest genital-to-genital HSV-1 transmission is rare. Given she likely sheds ~4 days/year, am I not at the same risk as a non-immunocompromised person during those brief periods? How much higher is my risk really? Can I have a safe sex life with her, and how can I lower my risk?
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Terri Warren, RN, Nurse Practitioner
1 months ago
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Have you ever in your life had a cold sore on your lip or in your nose? If yes, then you already have HSV 1.
People with genital HSV 1 rarely shed much after the first few years of having this infection and I, and the other posters on this forum, have not seen transmission via intercourse of HSV 1 genitally, but it has been documented in the literature, and most often happens when someone is newly infected.
In my opinion, your risk is not really higher than anyone else, because her genital HSV 1 is so inactive AND she's on suppressive therapya
Terri
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