GHSV1 Questions

[abcdefghsv1]

Hi Terri,

I was diagnosed with GHSV1 via swab one year ago. I’m looking to clarify some of the info I’ve read over the last year before disclosing.

In terms of GHSV1 recurring, I’ve see the following statements. Are they true?

-If you don’t have a second outbreak during your first year of infection there’s an 88% chance you’ll never have another outbreak.
-If you do have recurrent outbreaks you’re likely to have one every other year or less.
-After two years most individuals don’t have recurring outbreaks.

I’ve seen you mention recent research that says GHSV1 sheds only 4 days a year after two years.

-Has this research been published yet?
-Should it be interpreted as 4 individual days a year or 96 hours over the course of a year? If it is 4 individual days over the course of the year how long do shedding episodes generally last?
-If we factor in daily suppression, would that mean shedding would occur more like two days a year or less?

For GHSV2, research has said that transmission from a female to a male is 4% a year without condoms or suppression, 2% with condoms OR suppression, and 1% with both.

There appears to be no transmission statistics for GHSV1 because genital to genital transmission is said to be quite rare outside of an outbreak. Since we know GHSV1 is less active and sheds less than HSV2, can we infer what transmission rates for GHSV1 might be? Such as 1% without condoms or suppression, 0.5% with condoms OR suppression, and even less with both?

In your experience, do most serious couples where one person is GHSV1+ and the other is negative rely only on daily suppression for preventing transmission? It appears that many people who post in forums about their relationships with negative partners state they only use daily suppression. I’ve also read that some doctors don’t think condoms even make a difference for preventing the transmission of GHSV1 because it sheds so little and the risk is already very low. Would you agree?

Thanks!

[Terri Warren]

-If you don’t have a second outbreak during your first year of infection there’s an 88% chance you’ll never have another outbreak.
-If you do have recurrent outbreaks you’re likely to have one every other year or less.
-After two years most individuals don’t have recurring outbreaks.

These are correct statements

-Has this research been published yet?
-Should it be interpreted as 4 individual days a year or 96 hours over the course of a year? If it is 4 individual days over the course of the year how long do shedding episodes generally last?
-If we factor in daily suppression, would that mean shedding would occur more like two days a year or less?

I think your statistics are in the ballpark, yes
And I would guess that most couples in this situation only use suppression, but some who are really worried will use condoms. I think it depends upon how the uninfected person feels about the whole situation.

Terri

This information has not been published yet that I know of. It was presented at an International STD Research meeting a few years ago by Dr. Christine Johnston.
We don’t have the detail that you were requesting about number of days vs. number of hours.
I think suppression would likely cut the shedding days in about half, yes, though we have no research about that.

[abcdefghsv1]

Thank you for reassuring me that what I’ve read about GHSV1 is correct!

I often see people online debating whether or not it is necessary to disclose GHSV1 because shedding is infrequent and more than 50% of the population has OHSV1. There are several other experts who’ve been quoted questioning if GHSV1 even needs to be disclosed. I personally think both OHSV1 and GHSV1 need to be disclosed. It feels silly to not disclose something so common and so mild.

It seems like disclosing an established GHSV1 infection is more about building trust in a relationship than transmission since transmission is rare. If someone were to not disclose and have an outbreak several years into a relationship it could leave a partner feeling betrayed. Would you agree?

When I disclose I think I might say something along the lines of:

“Before our relationship moves forward, I want to let you know that I have genital HSV1. HSV1 is the virus that causes cold sores and you can get it genitally if someone who has oral HSV1 performs oral sex on you. Over 50% of adults in the US have HSV1 and if you already carry the virus, I can’t transmit it to you. The good news is that genital HSV1 actually sheds infrequently and rarely occurs (if ever), making genital-to-genital and genital-to-oral transmission rare. Because transmission is rare, some people choose not to disclose to their partners. I’ve only ever experienced one initial outbreak and statistically speaking there’s a good chance I may never have another one. However, I wanted to let you know my status in case I were to ever experience another outbreak so I could be honest with you and take the steps to prevent transmission. There is a daily supression medication I can take to reduce the chance of transmission, but since it is also already so low most experts feel it’s not necessary for GHSV1. I’m open to taking the daily suppression medication if it helps you feel more at ease.”

Do you think that is a fair disclosure?

[abcdefghsv1]

Thank you for reassuring me that what I’ve read about GHSV1 is correct!

I often see people online debating whether or not it is necessary to disclose GHSV1 because shedding is infrequent and more than 50% of the population has OHSV1. There are several other experts who’ve been quoted questioning if GHSV1 even needs to be disclosed. I personally think both OHSV1 and GHSV1 need to be disclosed. It feels silly to not disclose something so common and so mild.

It seems like disclosing an established GHSV1 infection is more about building trust in a relationship than transmission since transmission is rare. If someone were to not disclose and have an outbreak several years into a relationship it could leave a partner feeling betrayed. Would you agree?

When I disclose I think I might say something along the lines of:

“Before our relationship moves forward, I want to let you know that I have genital HSV1. HSV1 is the virus that causes cold sores and you can get it genitally if someone who has oral HSV1 performs oral sex on you. Over 50% of adults in the US have HSV1 and if you already carry the virus, I can’t transmit it to you. The good news is that genital HSV1 actually sheds infrequently and rarely reccurs (if ever), making genital-to-genital and genital-to-oral transmission rare. Because transmission is rare, some people choose not to disclose to their partners. I’ve only ever experienced one initial outbreak and statistically speaking there’s a good chance I may never have another one. However, I wanted to let you know my status in case I were to ever experience another outbreak so I could be honest with you and take the steps to prevent transmission. There is a daily supression medication I can take to reduce the chance of transmission, but since it is also already so low most experts feel it’s not necessary for GHSV1. I’m open to taking the daily suppression medication if it helps you feel more at ease.”

Do you think that is a fair disclosure?

[Author]

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