[Question #4665] Genital Herpes

28 months ago
I have genital herpes, but it has been dormant for over 30 years as I have been taking daily Valacyclovir on a daily basis. I have had ZERO breakouts or symptoms in that period of time. I have read that it is still possible to transmit the disease, but I am wondering if this is a general CYA comment that assumes that many people don't really know if they have had an outbreak.  If I truly have been symptom free for that many years, is there really any risk of transmittal?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
May I ask first how you were diagnosed with HSV 2?  Swab test from a lesion, blood antibody test, visual inspection only?
IF you were diagnosed via a swab test from a lesion, you are both infected and potentially infectious to others.  How infectious?  Not possible to say without the aid of daily home swabbing which is prohibitively expensive for most people.  If you are outbreak free and have been for 30 years, I would say that you probably shed on very few days but we cannot say that you don't shed virus ever.  So there is always a risk of transmission albeit small. 
Let me know what else I can answer for you

Terri
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28 months ago
So even if there are no open sores or cuts, and I can tell that there is no outbreak, I might still be shedding through unbroken skin?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
Correct, people can shed virus when there are no symptoms present at all. This happen on about 10% of days measured in people who do not have symptoms and on about 20% of days in people who are experiencing recurrences. This amount of viral shedding, as it is called, most often decreases over time. So for you, you have long duration of infection and daily antiviral therapy on your side in terms of lack of shedding. Antiviral therapy reduces the amount of shedding by about 60-70% also so now your numbers are really low. Add condoms and you are well below 5% now. But the decreases are not enough to suggest that you don't need to disclose your status to sex partners. But you can share that the shedding rate is very low

Terri
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27 months ago
Is there any way to know when the shedding is occurring in order to avoid having sex at that time?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
27 months ago
Unfortunately, no, there is no way to know when asymptomatic shedding is occurring as by definition there are no symptoms.

Terri
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