Asymptomatic shedding early on?

[oroinj]

Why is it that asymptomatic shedding occurs more frequently during the first year of having herpes, and most transmission during the first three months of a relationship? What happens to shedding/transmission rates as time goes on?

[Terri Warren]

There is less shedding as your immune system gets used to the virus and is better at handling it and responding quickly to reactivation. There is more transmission at the beginning of a relationship because generally, people have more sex then than they do later on in the relationship. Generally, shedding rates go down over time.

Terri

• This reply was modified 3 months, 1 week ago by Terri Warren.

[oroinj]

That sounds like it would make shedding increase over time, not decrease (assuming I understand it correctly and shedding is how the virus is spread). Is it possible to get tested for rate of asymptomatic shedding?

[Terri Warren]

That was an error on my part. There is LESS shedding as your immune system gets better. Whoops! So sorry. The only way to know about the shedding rate is to do daily home swabbing of the genital area. However, it is very expensive. However, some people do it anyway.

Terri

[oroinj]

Thank you. One last follow-up question: What is the likelihood of asymptomatically transmitting penis-mouth via oral sex? Does the presence of semen matter?

[Terri Warren]

I can’t really answer that because 1) I don’t know if the herpes being discussed is HSV 1 or HSV 2 – very different answers and 2) I don’t know your gender and 3) I don’t know if the infection is oral or genital that we are discussing. Sorry!

Terri

[oroinj]

Of course, that makes sense. 1) It is HSV2, 2) I am male, and 3) the infection is genital but asymptomatic.

[Terri Warren]

If you are asymptomatic and are assuming you have HSV 2 due to an antibody test, I would ask what was the value of your antibody test and have you done confirmatory testing like the western blot?

Terri

[oroinj]

Hi Terri,

I initially tested positive in 2019 after having been with a partner (female) for more than a year who was HSV2 positive but asymptomatic, when I noticed a very small lesion, which turned out to be my first and so-far only outbreak.

This past November I had a screening done as part of an overall health assessment, which came back with an IGG value of 1.61, with positive “supplemental” testing. Then less than a month ago I tested again (in context of conversations with a new partner) and tested positive with IGG value 1.15.

So no, I have not done a western blot test. Would there be any value in that at this point? Does the change in IGG numbers likely mean anything?

[Terri Warren]

Well, if your initial diagnosis was a swab from a lesion, then you don’t need a western blot. If you only think that you have HSV 2 due to these blood tests, I would highly recommend the western blot with these very low index values.

Terri

[oroinj]

Hi Terri,

Honestly, I don’t remember for certain if the initial diagnosis was with a swab or not, so I would like to do the western blot just to be safe. How can I do that? I live in NJ/NYC but currently traveling and will be back home mid-August.

If I still come back positive, would the western blot results tell me anything about amount of viral shedding? What would those low index values suggest to you (after presumably having the virus for at least 4 years now)?

[Terri Warren]

I can help you with the blot when you return. Just make an appointment at this website.
The western blot cannot tell you about viral shedding, no.
The low index value means nothing in terms of transmissibility or shedding.

Terri

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