[Question #7088] Herpes Transmission

7 months ago
Hello a few questions:

-risk rate of hsv2 transfer from female to male, girl is on valtrex 500mg once per day she started 4 years ago, but she has not had a outbreak ever since initial outbreak 8 years ago

-is this the proper dosage for her?

-how often could she be asymptomatic?  anyway to tell when someone is?

-I was actually tested and found out I had HSV-1, dumb question perhaps but can you get hsv1 from hsv2 by giving oral sex?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
The risk of transmission from a female on daily antiviral medicine to a male partner having sex about twice a week is about 1-2%. 
The dose of 500 mg per day of valacyclvoir for suppression is the correct dose.
If the woman has no symptoms, she is asymptomatic by definition.  I think you mean can you tell is someone is shedding asymptomatically?  No, not without a swab test.
You cannot get HSV 1 from HSV 2 - they are different viruses.

Terri
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7 months ago
Thank you for your response, follow up:

-Is that 1-2% with no protection?  and does study then say every time you have sex you possible have that percentage of a risk?

-Just curious of someone has no shedding how does a male contract hsv2?

-Is it true that where they had the initial outbreak is the point where its most likely transmitted from?

thank you. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
It is 1-2% (probably closer to 2%) without condoms.  Condoms would reduce the risk hugely beyond that.
Everyone who has HSV 2 sheds virus - that's how transmission happens.
Not necessarily, but usually.  Correct.

Terri
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7 months ago
-Was that 1-2% based on percentage of number of individuals or occurrences?
-I noticed you mentioned another drug that starts with the letter A, what is the difference and which do you recommend?
-Are you safe to give oral sex to someone with hsv2 or can someone contract that on the mouth?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
If 100 infected females were having sex one on one with 100 uninfected males, having sex about twice a week when no herpes symptoms were present, using antiviral medicine, 1 or 2 men would become infected during that time.
The other drug is acyclovir which is equally effective but needs to be taken twice daily vs. once daily.
Giving oral sex to someone who has HSV 2 is unlikely to result in oral infection but is possible.

Terri
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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
The duration of the studies varies - none for as long as a year, but for example, if they studied transmission rates for 4 months, the year data would be extrapolated from the four months.  People so shed less over time and more at the beginning of infection, so these are averages, not set in stone, the best we have.

Terri
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