[Question #8280] HSV1

46 months ago

GenitalHSV1 was transmitted to me on 5/13 confirmed by swab of the sore. I waited 4 months to get a blood test and that came back equivocal 1.03. What does that number mean? I began valtrex every day2 months prior to blood test. The person who gave it to me had no idea he had it,never had any symptoms, his blood test had a value of 52.3 which seems extremely high. Does the number value indicate the amount of antibodies in ur bloodstream?Or is my 1.03 number indicative of the virus being cleared from my cells?Should I go off valtrex to let my body build antibodies. I would prefer to stay on it to prevent transmission to my new boyfriend. Also,would getting the shingles vaccine help me to prevent transmitting HSV1? And if my bf got the shingles vaccine would that prevent him from getting HSV1? I am 53 he’s 46. Thank you

Terri Warren, RN, Nurse Practitioner

46 months ago

The index value of your partner suggests that he has had HSV 1 for a substantial amount of time. Your equivocal result is likely the result of you taking daily antiviral medication daily. I have seen it prevent antibody development for as long as two years. In essence, the antiviral is taking the place of your immune response right now. Since HSV 1 doesn't recur or shed very often, you might consider coming off of the daily antiviral medicine and see how you do. You could take it with recurrences only for a while.

The shingles vaccine won't help either of you deal with HSV 1 infection.

Also, the Igg test for HSV 1 misses 30% of HSV 1 infections compared to the gold standard herpes western blot. So it is possible that the test is missing your HSV 1 infection but I think it is more likely that the antiviral is keeping you from making an antibody response.

Has your partner actually been tested for HSV 1? If so, either he is uninfected OR the statement above is true. About half the US population has HSV 1 infection, so very common indeed.

Terri

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46 months ago

I started valtrex 4 days after my symptoms began. It was a severe outbreak. Stayed on it for a month,came off for a month and 1 sore appeared genitally. So I went back on med for 2 months (got a blood test IGg) for fear of transmitting it. So would it be better for me to stop the valtrex and allow my body to make antibodies? Will that prevent breakouts and or transmission? My boyfriend who transmitted it to me had a blood test which showed the 52.3. I am no longer intimate with him, but we still converse as friends. My current boyfriend never had a cold sore or any kind of symptom in his life. I’m concerned for his health and don’t want to transmit to him. I was up front & honest with him & just told him I have this, we haven’t had sex yet. Is oral or genital more transmissible? Is it safe to assume anal sex and oral sex from me to him would be safe seeing how I only had sores on my vagina and not on my butt?

I also take 100 mg of zinc, 1000 mg of lysine, and vitamin B complex to boost my immune system to try to keep it healthy to prevent further outbreaks? Is that ok? Thank you

46 months ago

He transmitted it to me after we had been together for a year and three months with unprotected sex. Which was weird after being with him for all that time he had no visual signs or anything on his mouth or his penis. So I can only assume it was in his semen. Also what is the percentage of me transmitting it to my new boyfriend?

46 months ago

I started Valtrex 4 days after my symptoms began it was a severe outbreak. Stayed on it for one month, came off at for a month, then 1sore appeared genitally, then went back on it for two months, got IGg tested 1.03. So would it be better for me to come off it to let my body make antibodies? Will antibodies prevent breakouts and transmission like Valtrex would? My boyfriend who transmitted it to me tested 52.3 I am no longer intimate with him but we converse as friends. My current boyfriend never had a cold or any symptoms so he has never been tested and he says he has never had anything like this. I am concerned for his health and do not want to transmit anything to him, I was up front and honest with him told him I had this we have not had sex yet. Is oral or genital More transmissible?

Is it safe to assume anal sex is safe seeing how I only had vaginal sores? Is oral sex safe either way?

What is the percentage I can transmit this to him?

What is meant by shedding? The skin sheds? The man who transmitted it to me never had any symptoms ever. I got it after 1yr 3 months with him

Terri Warren, RN, Nurse Practitioner

46 months ago

Oral HSV 1 is more transmissible than genital HSV 1.

Anal sex is not really safe either as the virus is in the entire set of nerves, including around the anus.

We don't have transmission data on HSV 1, I'm afraid, but we do know that the shedding of the virus is way less than HSV 2.

Shedding is when the virus comes off the nerve and the tissue and it can happen with and without symptoms

Would your boyfriend agree to be tested to see if he might be infected and not know it? I'm not clear that you going off Valtrex is a good idea now IF you have a partner who is uninfected. But if he tests positive also, then I think you could consider coming off suppression and letting your body develop an immune response

Terri

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46 months ago

Thank you. So I can shed the virus through my skin? Are there any other ways that I shed? Since I only had genital sores when I had my 1st breakout,does that mean I do not have it orally? I’ve never had a cold sore on my mouth. If that’s the case,is it safe to kiss and give my bf oral sex?

The man who transmitted it to me has never had any symptoms. He has 3 young children, Said he lost his wife to cancer 4 years ago so he up’ed his life insurance and he said he was tested for AIDS n stuff and it was negative, would they test for HSV if you bought life insurance? But he did tell me that every 1.5-2 years he gets a high fever and burning in his lower back, Lasts a couple days then goes away. Could that be his symptoms?

Why is it better to let my body develop an immune response? Vs. staying on meds? If I were to come off meds and then plan to have intercourse with my bf, how soon should I start the medicine b4 we have sex to prevent transmission. Say we decide to have sex once a month without condom usage while the virus is suppressed? Thank you again for your help

Terri Warren, RN, Nurse Practitioner

46 months ago

Skin is really not the right word. You shed virus through your very thin skin of the genitalia - mucous membrane as well.

If you only had symptoms genitally, then you probably don't have it orally. That's not a guarantee, but it is unlikely.

They would not normally test for herpes in a life insurance exam, no, as it has no impact on the duration of one's life. A high fever and back burning do not sound like herpes symptoms, no.

But remember that about half the population in the US has HSV 1 infection, and of those infected with HSV 1, 70% would report that they had no symptoms. That's actually not correct, as symptoms can be minor or mixed up with other things, but that is the perception. Also, people can have outbreaks inside the nose and most people don't think of those are herpes outbreaks.

Eventually, you MAY wish to come off meds and see how you do. Right now, in essence, the medicine is taking the place of your immune response somewhat, and that's not a bad thing.

If you do come off meds, but wish to use them to reduce transmission, you should start taking them daily for 5 days in advance of sexual contact with an uninfected partner.

Hope this is helpful.

Terri

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