[Question #2933] Questions about G-HSV1
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93 months ago
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I was diagnosed with G-HSV1 7 years ago and have had three outbreaks (primary, one six months later, and one last February after nothing for 6 years.) Needless to say this has been emotionally traumatic. I guess I just want to know - how big a deal is this? How should I be thinking this in comparison to HSV-2? My questions are below:
1) What is the subclinical shedding rate per year (percentage) for HSV1 as compared to HSV2?
2) What is the genital-to-genital transmission rate for HSV-1? How common is it?
3) I haven't read a lot about suppressive treatment therapy for HSV-1. Even though I don't have many obvious outbreaks, I'm still very nervous about asymptomatic shedding and wonder if going on a daily suppressive treatment could potentially cut down on that.
4) How common is it for HSV-1 to spread to other places in the body (e.g. mouth and eyes) during subsequent outbreaks (not primary infection)? I had slightly red, itchy eyes around the time of my last outbreak (though I also have had since) so I'm not sure if I should be linking them.
Thank you so much.
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Terri Warren, RN, Nurse Practitioner
93 months ago
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It is not a big deal.
HSV 1 genital infection sheds on about 5% of days measured
Genital to genital transmission has been documented but is really uncommon
You could certainly do daily antiviral therapy if you are having sex with someone who tests negative for HSV 1 as another measure to reduce transmission
Once your infection is well established (about 3-4 months), it is extremely unlikely you would transmit it to a new location on your body
Terri
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HSV 1 genital infection sheds on about 5% of days measured
Genital to genital transmission has been documented but is really uncommon
You could certainly do daily antiviral therapy if you are having sex with someone who tests negative for HSV 1 as another measure to reduce transmission
Once your infection is well established (about 3-4 months), it is extremely unlikely you would transmit it to a new location on your body
Terri
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93 months ago
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Thank you so much. A couple follow ups:
1) Is the 5% standard for early after the infection is acquired? Does shedding decrease over time?
2) My partner is negative for HSV-1. If I considered antiviral therapy for G-HSV1, what dosage would you recommend? I've read that G-HSV1 is inherently less responsive to Valtrex than HSV-2; as such, does the dosage need to be higher? And is suppressive therapy common for G-HSV1 or do most people not bother given infrequency of subclinical shedding and outbreaks?
Many thanks.
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Terri Warren, RN, Nurse Practitioner
93 months ago
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The 5% is an average - probably represents new and old infections mixed. We simply don't have as much data on HSV 1 behavior genitally as we do genital HSV 2.
So remember that the IgG test misses 30% compared to the western blot so he may or may not be infected. The daily dose of suppression in your situation is 500 mg once a day. I don't believe that the dose does need to be higher. Many of my patients use suppression for HSV 1 when having sex with someone who is not infected.
Terri
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So remember that the IgG test misses 30% compared to the western blot so he may or may not be infected. The daily dose of suppression in your situation is 500 mg once a day. I don't believe that the dose does need to be higher. Many of my patients use suppression for HSV 1 when having sex with someone who is not infected.
Terri
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