GHSV-2, first time mild outbreak

[Iwillbeokright]

Hi Terri, 28F here. I was recently diagnosed with GHSV-2 based on a swab. I’ve never had an outbreak before orally or genitally and it’s something I keep an eye out for since I am aware of HSV. But this outbreak didn’t look like an intense outbreak at all, I had a single small blister which I would not have thought twice about had I not known about how HSV can present in multiple ways. I had no prodrome (the lesion appeared quite suddenly), but had been going though emotional stress for a week prior to the lesion. I also started my period the next day.

Questions:

– what seems the more likely explanation? That this is a new infection (I had a protected sexual encounter 6 days prior to the appearance of the lesion), that this is the first outbreak I’m experiencing of an established dormant infection, or that I might already have HSV1 and so this first GHSV2 outbreak is mild.

– what does it mean to have such a mild outbreak? It really looks nothing like the horror outbreaks I see pictures of and people discussing. Honestly, I wonder how many people who aren’t informed would miss such a symptom. But does it mean that I might be shedding less than someone who gets severe outbreaks?

– I disclosed to my sexual partner who is going to get tested too but in the absence of lesions he will have to get an igg blood test. In case he is not infected and we decide to continue a sexual relationship, should I be doing anything different? We already use condoms and I’m OK with taking antivirals. Would doubling up on antivirals on the day of sex further reduce transmission risk? Like say, 500mg daily, and 1000mg on the day of sex. If so, how many hours prior to sex should I ideally take the antivirals? Can he also take preventative antivirals?

Thank you for your help! I’m definitely upset and obsessing over this a bit but I’m hopeful I’ll be able to carry through eventually.

[Terri Warren]

– what seems the more likely explanation? That this is a new infection (I had a protected sexual encounter 6 days prior to the appearance of the lesion), that this is the first outbreak I’m experiencing of an established dormant infection, or that I might already have HSV1 and so this first GHSV2 outbreak is mild.
I think the first option is very unlikely – condoms reduce transmission from men to women by 96%. The later two are both possible and since we don’t know your HSV 1 status, I can’t say.

– what does it mean to have such a mild outbreak? It really looks nothing like the horror outbreaks I see pictures of and people discussing. Honestly, I wonder how many people who aren’t informed would miss such a symptom. But does it mean that I might be shedding less than someone who gets severe outbreaks?
No, it says nothing about your shedding rate but it does suggest a recurrence. An antibody test done at the time of the swab would have told you that.

– I disclosed to my sexual partner who is going to get tested too but in the absence of lesions he will have to get an igg blood test. In case he is not infected and we decide to continue a sexual relationship, should I be doing anything different? We already use condoms and I’m OK with taking antivirals. Would doubling up on antivirals on the day of sex further reduce transmission risk? Like say, 500mg daily, and 1000mg on the day of sex. If so, how many hours prior to sex should I ideally take the antivirals? Can he also take preventative antivirals?
If he is positive also, it’s not an issue. If he is negative, and you take daily antivirals and he uses a condom, the risk of transmission to him is very low indeed. You should be on antivirals for 5 days to be fully effective and you could double up though we don’t know for sure how much benefit that would be.

Terri

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