Asymptomatic HSV2 for 12+ years

[mintlavender]

Good morning Terri,

12 years ago I met my partner. From our very first date, he told me he was HSV2 positive with continuous outbreaks. I appreciated and valued his honesty from the start.
We were very careful at the beginning using condoms and sleeping in between his outbreaks.

A few years into our relationship, I got tested and came back with a low positive. My OBGYN recommended I do not retest, it semmed like an old infection and probably positive because of my partner’s history.

He started taking antivirals so that I could get pregnant. 2015 I tested again, HSV2 IGG came back postive at 8 level.

I have been completely asymptomatic. No initial outbreaks. No rashes. No yeast infections or UTIs.No cuts. Nothing that would ever resemble pain or burning sensation. I’ve been under stressful situations. Sick with high fevers. Nothing in my life for the past 10 years have initiated an outbreak or anything that resembles an outbreak. (I guess I have a good immune system!)

I tested again August 2023. HSV2 IGG came back 7.75.

I’m positive, but completely asymptomatic.

My questions are:

– Would you recommend I do the Western Blot? I know my levels are high, but is there hope I am not positive due to the lack of symptoms for the past 10+ years?

– Will I ever have an outbreak after so many years?

– If in the future I have another sexual partner, how can I protect him from transmission? My OBGYN would never prescribe antivirals due to me never having an outbreak. She says my levels of transmission are extremely low. Please advise.

Thank you for all you do.

[Terri Warren]

– Would you recommend I do the Western Blot? I know my levels are high, but is there hope I am not positive due to the lack of symptoms for the past 10+ years?
You could do the blot, but I would bet, with a relative high degree of certainty, the you are truly infected.

– Will I ever have an outbreak after so many years?
You might, yes, and remember that outbreaks can occur anywhere in the boxer shorts area.

– If in the future I have another sexual partner, how can I protect him from transmission? My OBGYN would never prescribe antivirals due to me never having an outbreak. She says my levels of transmission are extremely low. Please advise.
Well, I disagree completely with extremely low. We know that people who are totally asymptomatic shed virus on about 10 out of 100 days, and you might shed a bit less due to the duration of your infection. But she is wrong to deny you antiviral medication of you are going to be sexually active with other partners, in my opinion. I have more than 40 professional publications in very good journals like JAMA and New England Journal of Medicine. I would be willing to put my herpes knowledge against most any ones, honestly.

Terri

[mintlavender]

Thank you Terri.

I forgot to clarify I’m a 37(F) 10+ years of being HSV2 positive. Completely asymptomatic.

I guess my follow up questions are:

How can I protect future sexual male partners from transmission?

[Terri Warren]

Use condoms and take daily antiviral medication, either acyclovir 400 mg twice a day or valacyclovir 500 mg once a day at about the same time each day. Be aware of any symptoms in the boxer shorts area, disclose your status to your partner.

Terri

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