A.  If we use condoms and I am on a daily antiviral pill

B. If we do not use condoms but I take my daily antiviral pill      ( in both scenarios we will avoid sex during outbreaks) 

Can you please give me answers in percentages?  Sorry I am not very good at math! Haha

Also, I am scared that I could potentially give hsv-1 to an uninfected partner orally if he gives me oral sex. Could you please explain to me if this occurs often? 

Thank you 

We don't really have a way to compare HSV 1 and HSV 2 except to know about the rates of shedding.  We believe that HSV 2 sheds on about 14-15% of days measured while HSV 1 shed on about 5% of days measured (I believe there is a new study coming out about this in not too long a time)

I personally have not seen a patient with a new case of HSV 1 who had no received oral sex at the most recent sexual encounter.  I have translated that into it being extremely unlikely that someone would transmit HSV 1 through intercourse except it has been documented in the literature.  Both Drs. Hook and Handsfield also have not seen this.  The way we would know it was genital to genital transmission for sure would be if someone said no, I did not receive oral sex at this sexual encounter and now I have new HSV 1 genital infection, right?  To be very clear, there is somewhat of a jump here in that the oral sex might not have transmitted it, but at any rate, I think the risk is very very low.

Terri

I also wanted to clarify something...when I got diagnosed my lesions appeared in areas where there would be skin to skin contact if I were to be having sex with an uninfected male even using a condom ( these areas include the skin close to the outer labia and the inner thigh) . Does the virus shed around this area? 

Also, according to the CDC the statistics for HSV-1 is 47% do you think this is accurate or there is actually a higher proportion of the population who is infected? 

Yes, the risk of him getting it orally is slim indeed as HSV 1 in the genital area shed infrequently.  It is not zero but it is low risk

The thigh does not shed but the labia does

The 47% infection rate is for people ages 14-49 and that is correct, yes

Terri

1. How effective is Valtrex in preventing asymptomatic shedding of HSV-1? I ask this question because my partner would like to reach a point in our relationship where we can be intimate without the use of condoms. I would only feel comfortable doing this if I can take a daily antiviral pill that I am sure would work to reduce asymptomatic shedding of the virus. 

2. Does the virus shed everywhere? As in the inside of the vagina, in the outside of the genitals, anal region etc? 

3. When you get pregnant does your OBGYN tests you for herpes via a blood test? 

4. Does being on a daily antiviral while pregnant affect the baby?

5.  I have heard although I am not sure that HSV-1 is less susceptible to Valtrex and therefore a higher dose would be required for it to actually have an effect. What would be the ideal dose to reduce asymptomatic shedding of HSV-1 ? Would it be 1g a day? Would it be safe for the body to take this dose everyday?

8. Can a person get herpetic whitlow by fingering an infected partner? 

1. How effective is Valtrex in preventing asymptomatic shedding of HSV-1? I ask this question because my partner would like to reach a point in our relationship where we can be intimate without the use of condoms. I would only feel comfortable doing this if I can take a daily antiviral pill that I am sure would work to reduce asymptomatic shedding of the virus.

We don't have data on reduction of shedding of HSV 1 with antiviral medicine. 

2. Does the virus shed everywhere? As in the inside of the vagina, in the outside of the genitals, anal region etc?

It shed from the thin skin or mucous membrances, vagina,labia, perineum, anus.

3. When you get pregnant does your OBGYN tests you for herpes via a blood test?

Some do and some don't

4. Does being on a daily antiviral while pregnant affect the baby?

Most clinicians recommend stopping during the pregnancy and restarting around 34 weeks

5.  I have heard although I am not sure that HSV-1 is less susceptible to Valtrex and therefore a higher dose would be required for it to actually have an effect. What would be the ideal dose to reduce asymptomatic shedding of HSV-1 ? Would it be 1g a day? Would it be safe for the body to take this dose everyday?

It may be slightly less effective for HSV 1 than HSV 2. I think 1 gram a day would be a great plenty,yes

8. Can a person get herpetic whitlow by fingering an infected partner?

If there is a significant break in the fingers of the person doing the fingering this is possible, but because HSV 1 doesn't shed often, I think it is very very unlikely

Terri