GHSV2 Transmission & Valtrex

[Fesenjoon]

Hello,

I’m a 44 year heterosexual male and I’ve tested positive for HSV2 in my genital and oral area five years ago (but tested negative for HSV1). I’ve had 2 genital outbreaks per year in the first 2 years. None for the third year and now once a year for the fourth and fifth year. Less occurances for the oral outbreaks (once every 18 months).

My concerns is about transmitting to a future partner and being able to safely impregnate a future partner. So my questions are:
1) given my situation, what are the transmission rates to negative female partner?
2) does it makes sense for me to take valtrex daily? And is it well tolerated for long term usage (e.g. 10 years +).
3) how can I safely impregnate a future partner? I assume I will need to be on anti-virals but no condom? Or do I need to think about IVF?

Thank you,

[Terri Warren]

1) given my situation, what are the transmission rates to negative female partner?
In a longer term relationship, the risk of transmission of HSV 2 is about 10% per year doing nothing.
2) does it makes sense for me to take valtrex daily? And is it well tolerated for long term usage (e.g. 10 years +).
Yes, and it reduces transmission by 48%. Condoms reduce transmission by 96$
3) how can I safely impregnate a future partner? I assume I will need to be on anti-virals but no condom? Or do I need to think about IVF?
This is a decision that the two of you should make. Turkey basters and a jar of semen at home would work also!

Terri

[Fesenjoon]

Is there any information about GHSV2 shedding days over time? I understand that shedding decreases over the long term. I was wondering if the 10% transmission rate of M-to-F for HSV2 decreases over time.

[Terri Warren]

The studies have looked at that and we find that shedding does decrease over time, but not significantly after about 2 years of being infected.
The oral outbreaks are rare and I’m very surprised that you have them as often as you do. Have they been swabbed with every outbreak?
Terri

[Fesenjoon]

I’ve only been swabbed for the genital sores which confirmed HSV2. I also did a blood test twice which came back positive for HSV2 (but negative for HSV1). Do we know what the average shedding rates are after two years for HsV2 (is it the 10 days per 100 days?)

[Terri Warren]

People who test accurately positive for HSV 2 by antibody test but never have sores shed virus on about 10 out of 100 days. People who test positive for HSV 2 from lesions, so symptomatic people, shed virus on 20 out 100 days. We don’t have specific statistics about shedding at various time points after infection as we do for HSV 1, ironically.

Terri

[Fesenjoon]

Last question, as I have ghsv2 would oral sex performed on me have a chance of transmission to the other person mouth?

[Terri Warren]

Yes, there would be some small risk of someone giving you oral sex and acquiring this orally but it would be rare. In your first post, you mentioned having HSV 2 genitally and orally but as I look back on this, you’ve never had a positive oral swab for HSV 2, is that correct?

Terri

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