GSHV1 Transmission , Conceiving, Condom usages and risks

[warrior76]

Hi Terri,
I am a male. It’s been 8 months since I got diagnosed with GHSV1 as I was exposed orally from a massage therapist. I have had around 5 to 6 minor outbreaks over the span of 8 months now.
I have some questions related to transmission , conceiving and condom usages and risks.
My partner is a long time partner and she does not have HSV.

Could you please address them?

1) I am using this approach for sexual activity. The men’s underwear comes with a fly option where it is possible to open only the penis part and cover the complete boxer area. The penis will be covered with condom with underwear on during sexual activity. Do you think this is a better option to stop asymptomatic transmission?

2) I am not on antivirals as I stopped getting outbreaks. Can I continue without taking antivirals?

3) My partner is allergic to Latex condom and lubricants. I am using Polyurethane condoms with coconut oil. Last night, Unfortunately, the condom got broke during sexual activity. I was not having an outbreak and I was not on antivirals. How likely it is possible to transmit HSV to my partner ? . We are planning to wait for next 1 week to see if she shows any symptoms if it has got transmitted.

4) My partner and I stopped indulging in oral sex because of the risk. We are planning to have a baby. She is worried that we cannot have direct sex to conceive. How likely it is possible to transmit the virus without protection ? Should we try other approaches ? Can the semen contain the virus ?

5) In case , if my partner get infected with HSV1 genitally, Can she ever conceive and deliver safely without any harm to baby? Should any other alternatives like surrogacy be considered ?

[Terri Warren]

Before I answer your questions can you tell me exactly how you were diagnosed with genital HSV 1? Also, you are having way more outbreaks than anyone I’ve ever heard of with genital HSV 1 so I’m not sure what is going on there.

1) I am using this approach for sexual activity. The men’s underwear comes with a fly option where it is possible to open only the penis part and cover the complete boxer area. The penis will be covered with condom with underwear on during sexual activity. Do you think this is a better option to stop asymptomatic transmission?
Not really, no.

2) I am not on antivirals as I stopped getting outbreaks. Can I continue without taking antivirals?
You can, of course, but with your frequency of outbreaks, I would probably recommend that you continue.

3) My partner is allergic to Latex condom and lubricants. I am using Polyurethane condoms with coconut oil. Last night, Unfortunately, the condom got broke during sexual activity. I was not having an outbreak and I was not on antivirals. How likely it is possible to transmit HSV to my partner ? . We are planning to wait for next 1 week to see if she shows any symptoms if it has got transmitted.
Normally I would say the risk is very low but with your frequency of recurrences, you are an exception. I hope she continues to not show symptoms. I am assuming she tests negative now for HSV 1?

4) My partner and I stopped indulging in oral sex because of the risk. We are planning to have a baby. She is worried that we cannot have direct sex to conceive. How likely it is possible to transmit the virus without protection ? Should we try other approaches ? Can the semen contain the virus ?
You could ejaculate into a container and insert the semen with a turkey baster. Semen is not a good carrier of HSV 1.

5) In case , if my partner get infected with HSV1 genitally, Can she ever conceive and deliver safely without any harm to baby? Should any other alternatives like surrogacy be considered ?
Most definitely she can conceive and deliver safely! She would go on antivirals at the end of her pregnancy and if no lesions are present, she would deliver vaginally.

Terri

[warrior76]

Hi Terri,
Thank you for your comments.

I was diagnosed with blood test. I did all STD tests including HSV IGM and IGG two times within first month after exposure. I got negative results. I knew something was wrong as my initial symptoms were burning sensation during urination , tiredness and an ulcer near Anal area within one week of exposure.

So, I did only HSV IGG test again after 1 month of exposure and I got it positive.

Later, when I had my first sexual activity with my partner with protection , I got blisters on my penis after 2 days. dermatologist confirmed it is herpes and prescribed anti viral medications. I took them for almost first 6 months only when I had outbreaks.

I wanted to ask few questions again.

Could you please address them ?

1. For the question you asked before, yes my partner is not showing any symptoms. It has been 4 days since my condom broke during activity. I am not sure if she has got infected or not. I haven’t got her tested till date as she didn’t show any symptoms. What do you suggest ?
2. Another thing I wanted to inform you that I got 5 to 6 outbreaks in first 6 months of exposure. It’s been 2 months since I have had any outbreaks. Coincidently, I took pills to increase my vitamin D and B12 levels. When I was about to finish my vitamin tablets course, I noticed my frequency of outbreaks started to reduce. I am not sure if it has any relation to herpes. What do you think ?
3. My doctor here said that if I take one valtrex 500 mg tablet before 2 hours of sexual activity , then it will deactivate the virus. What do you think ?
4. I am not sure if it is there in my mouth as in the initial days of exposure I was tensed a lot and I don’t know if I have touched my mouth after touching my genitals. What would you suggest ?
5. Would there be any possibility to have got exposed to HPV along with HSV? I heard there are no HPV tests for men. What is your opinion on this ? I haven’t got any symptoms for HPV till date.

[Terri Warren]

1. For the question you asked before, yes my partner is not showing any symptoms. It has been 4 days since my condom broke during activity. I am not sure if she has got infected or not. I haven’t got her tested till date as she didn’t show any symptoms. What do you suggest ?
So is it correct that your partner has actually been tested and is negative for HSV 1? If she is wanting to know if this experience caused her to be infected, then she should wait at leat 8-10 weeks to get an IgG test.

2. Another thing I wanted to inform you that I got 5 to 6 outbreaks in first 6 months of exposure. It’s been 2 months since I have had any outbreaks. Coincidently, I took pills to increase my vitamin D and B12 levels. When I was about to finish my vitamin tablets course, I noticed my frequency of outbreaks started to reduce. I am not sure if it has any relation to herpes. What do you think ?
I think it is highly unusual that someone with HSV 1 would have 5-6 outbreaks in six months and I doubt that the vitamins have anything to do with the decrease in outbreaks.
3. My doctor here said that if I take one valtrex 500 mg tablet before 2 hours of sexual activity , then it will deactivate the virus. What do you think ?
I think that’s malpractice. We know that it takes 5 days of dosing with Valtrex to reach optimal level to reduce transmission.

4. I am not sure if it is there in my mouth as in the initial days of exposure I was tensed a lot and I don’t know if I have touched my mouth after touching my genitals. What would you suggest ?
I think without symptoms, if I were you, I would assume I am not infected orally.

5. Would there be any possibility to have got exposed to HPV along with HSV? I heard there are no HPV tests for men. What is your opinion on this ? I haven’t got any symptoms for HPV till date.
If you develop what looks like a wart in the genital area, you should have it evaluated. We know that the vast majority of sexually active people have had or do have HPV. There is no easily available test for HPV for men, that is correct.

Terri

[warrior76]

Hi Terri,
Thanks for the updates.
I have last set of questions i want to ask.
Could you please address them ?

1) Have you seen any case with genital to genital transmission without indulging in oral sex till date ?

2) How likely it is possible to transmit GHSV1 asymptomatically when there are no outbreaks to my female partner ?

3) If I have to plan for a kid, what should be the dosage of valtrex I should take everyday in order to prevent transmission to my partner genitally ?

4) Are there any prodromal symptoms for asymptomatic viral shedding ?

5) Sometimes my body itches a lot. Sometimes I feel itchy near private area. Does it mean my body is shedding the virus ?

[Terri Warren]

1) Have you seen any case with genital to genital transmission without indulging in oral sex till date ?
Not personally, no.

2) How likely it is possible to transmit GHSV1 asymptomatically when there are no outbreaks to my female partner ?
We don’t have that data, sorry.

3) If I have to plan for a kid, what should be the dosage of valtrex I should take everyday in order to prevent transmission to my partner genitally ?
500 mg once a day is the usual dose for suppression. We don’t know exactly what the effectiveness is for HSV 1 genital infection

4) Are there any prodromal symptoms for asymptomatic viral shedding ?
Often no, no

5) Sometimes my body itches a lot. Sometimes I feel itchy near private area. Does it mean my body is shedding the virus ?
Not necessarily. Genital itching is very common, even in people without HSV.

Did the dermatologist do a swab test of the blisters?

Terri

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