[Question #7083] Hsv1 genital

9 months ago
Hello, do you have any information on what causes shedding of hsv1 genital? The reason I ask is I had labiaplasty months ago and wondered if that may cause more shedding of the virus because of scar tissue etc. As far as I know I’ve not had any outbreaks since the initial just over 2 years ago. Why is it that some people will shed more than others is there any way of knowing if I am contagious more than the average 4 days a year? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
There is no reason to think that a labiaplasty would cause more or fewer HSV 1 genital outbreaks.  The surgery itself might have caused an outbreak due to irritating the nerves in that area, but you aren't describing an outbreak related directly to the surgery time. 
We don't really know why some people shed more often than others but it is likely related to some immune system response.  The only way to know the rate of viral shedding is to do daily home swabbing of the genital area for some extended period of time, say 3 months.  But that process is very expensive - about $140 a swab in most places - which makes this impractical for the majority of people.  So you will just need to rely upon the research that's been done already on HSV 1 genital shedding.  This research indicates it happens rarely for most people, especially after a couple of years of having this infection

Terri
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8 months ago
Thanks Terri. I have a couple more questions. Is it safe to assume that if you have no outbreaks or rarely have outbreaks then you are one of those people who rarely shed the virus without symptoms and that viral shedding is mostly linked with the amount of outbreaks you have? 
Also for people that are positive for hsv1 but can’t recall having a cold sore Is it very likely that these people still shed the virus without symptoms, maybe at a similar rate to those with hsv1 genital for more than 2 years?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
8 months ago
So we know from studies of HSV 2 that those with symptoms shed virus about twice as often as those who have no symptoms.  We assume that something similar goes on with HSV 1 infection. 
It would be nice to make assumptions about shedding of HSV 1 orally in a person without symptoms but we simply do not have data to support that concept.  We do know that HSV 1 oral infection sheds way more often than those with genital HSV 1.

Terri
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8 months ago
Thanks Terri. 
If am I with a HSV1 negative partner and suppression therapy isn’t available where I come from but we don’t want to use condoms anymore is the risk still very low if I have had Genital HSV1 for just over 2 years? Is it necessary to use condoms forever or will there be a time to assume it is safe not to use them? 
8 months ago
Also about the 4 days a year viral shedding, is most shedding enough to infect someone or is the risk of transmission very low even on shedding days? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
8 months ago
The risk of transmission of HSV 1 to a partner through intercourse after you have been infected for 2 years is very low indeed.  The risk of transmission when virus is shed is very real.  Does it result in transmission every time?  Probably not. 

Terri
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