ghsv-1 Qs

[throwaway_today]

-What are your thoughts on the risk of dating someone who has had ghsv-1 for about 6 months, and if the risk is still low in a long term relationship. She’s on antivirals and has only had the initial outbreak so far.

-When saying you haven’t seen g to g hsv1 transmission, how do you make that assumption? For example, if someone is diagnosed with ghsv-1 and their partner ends up getting it genitally, do you rule them out completely if they had oral at any time just because genital shedding is so much lower, or is there another process you go through when determining transmission?

-I’ve heard some people compare ghsv-1 transmission risk to be about the same as someone getting pregnant on birth control. Would you say that is a fairly accurate comparison? Would that be true for people only at 6 months of infection?

[Terri Warren]

You ask a great question. I have not diagnosed anyone with genital HSV 1 positive through a swab that has not received oral sex in the past two weeks. Granted, that doesn’t ensure that the transmission was through oral sex but we know that that is the usual method of acquiring HSV 1. Are there exceptions? Probably, but I personally have not diagnosed someone with genital HSV 1 who has NOT received oral sex in the past two weeks.

We know that people at about 6 months out from a new infection shed virus on about 6% of days. Taking antiviral medication reduces that considerably, but we don’t have the data on exactly how much. And then using condoms also reduces transmission as well.

Perhaps the birth control analogy is about right?

Terri

[throwaway_today]

Maybe I’m overestimating how many sex encounters include oral. Are there other bits of information that help you make the assumption that it isn’t G-G transmission when cases come in? Things like ‘plenty of GHSV-2 patients come in and get diagnosed with out having had oral, and no GHSV-1 cases ever come in where they haven’t, so we can make assumptions about how it mainly transmits”. Or do you make that assumption based on your thoughts of how shedding statistics would play out? Let’s say the positive transmitting partner had a positive genital swab, would you still assume they passed it on to their negative partner orally since cross infection is rare?

I’ve read forum posts of people claiming that GHSV-1 is in a weakened state because of it not being in it’s preferred location, and that it may have trouble transmitting because it literally isn’t capable of bringing enough virus to the surface when it’s not in an outbreak. Have you heard of any studies or have speculation on that line of thinking, or is the only reason ghsv-1 is considered weakened is because of its lower shedding rate?

I’ve heard the amount protection condoms give men against hsv is sort of debated. Do you know of any data specific to that question?

Do you have a link showing the most recent studies of ghsv-1 shedding over time? Like a chart showing the decrease as the months go by?

[Terri Warren]

THe first part of your question is a bit confusing to me. If someone had a genital lesion that tested positive for HSV 1 and they had just had sex with someone who then acquired HSV 1 genitally, yes, I would think that was genital to genital transmission. HSV 1 does have a preferred location and it is the oral area. It is true that I have not seen a case, personally, of someone with new genital HSV 1 infection that has not received oral sex in the past two weeks. GEnital to genital transmission of HSV 1 has been documented in the literature, but most of us have never seen this (without oral sex in the mix).

It isn’t that HSV 1 is in some sort of weakened state genitally, it is that it doesn’t like being there so it is rarely active there, especially after being there for a while.

We know that condoms reduce transmission from females to males by 65% – that is the work of Dr. Anna Wald.

Dr. Christine Johnston is the person who does most of the research into HSV 1 genital infection at this time. I have certainly seen her slides on this topic but I’m not clear if she has published this data yet.

Terri

[Author]

Posts