[Question #4826] GHSV1 transmission and prevention

27 months ago
Hi there
I am a heterosexual female with GHSV1.
I have done extensive reading on the virus, and wanted to ask a couple of questions, to hopefully consolidate my knowledge and ease my mind.
1) From my readings, my understanding is that genital to genital transmission of GHSV1 would be extraordinarily rare (e.g. you would probably have more chance of being hit by lightning). Can you please let me know, of the three experts on your panel, have any of you ever seen genital to genital transmission happen (female to male)? 
2) Given that genital to genital transmission is extremely unlikely, do you usually recommend the use of condoms or suppressive therapy to prevent infection when the partner of a GHSV1 person has tested negative to a HSV1 blood test (which I understand is not always accurate). 
Thank you for offering this valuable service.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
27 months ago
1.  I don't believe that any of us have seen genital to genital transmission of HSV 1 but it has been documented in the literature.  But here's the deal - I've not seen anyone with genital HSV 1 as a new infection who has not received oral sex shortly before, but they have also had intercourse, so I guess we can't say for certain. 
2.  That is an individually determined issue.  I personally do recommend disclosure of HSV 1 genital infection prior to intercourse because it has been documented to happen.  In addition, if you did transmit without disclosure it could become a legal issue - you knew you had a sexually transmitted infection and did not disclose.  In some states, that's a crime.  So you can see that it is a complicated issue.  At a minimum, I would encourage you to take daily antiviral medicine and encourage condom use. 
The other thing about disclosing is that IF you feel prodromal symptoms at some point, you an alert a partner that this might not be a good time to have intercourse and instead engage in other kinds of sexual activity. 
And you are correct - the HSV 1 IgG antibody test misses 30% of HSV 1 infections, compared to the gold standard western blot.
Please let me know what other questions you might have.

Terri

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27 months ago
Thank you for the clarity. I have disclosed :).
You recommended daily antiviral medication as a minimum for GHSV1 to prevent transmission.  Are there any long term side effects of ongoing use? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
27 months ago
No, not that we know of and it's been on the market since 1982.
Good for you for disclosing.  I know it's difficult but when all the facts are known about GHSV1, most people can handle this news.  And if they can't, well, that's not a happy thing but in my opinion, the right thing.

Terri
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