HSV1 transmission and odds

[Ozworth]

Hi,

I recently starting dating someone who has revealed to me that she has oral HSV1. I am HSV1 and HSV2 negative. She told me that she gets blisters around her lips every 1 or 2 years (since she was 18 – she is 45 now). I am concerned about the chances of contracting HSV1 from her, the “odds” that I could contract it, and to what level of severity would it be for me if it was contracted.

1. You had stated the following to another question in this forum: “You seem quite concerned about getting HSV 1 but are you willing to use that as a significant measure of who you will be partnered with? Some people will make the decision, many won’t”. This is a valid question and one that I am currently struggling with. When I look at pictures on the Web of oral HSV1, I see some very severe problematic cases. Its not necessarily a small blister that appears then disappears in 2 weeks but appears to often be a MAJOR outbreak of blisters around the lips or on the face or nose etc (scary stuff).. and often reappears monthly or several more times a year. Are these the norm or more the exception (50/50 ? 80/20 ? ) ? I suppose there is no way of knowing how it might manifest itself in me if I was to contract it from her ?

2. I have heard that if you avoid contact (kissing or oral sex) just before, during and about 2 weeks after outbreak heals to normal skin, then the odds of transmission are very small in the non-outbreak periods – is this correct ? If so, what are the odds (if known) ? And would taking Acyclovir or Valtrex daily (anti viral therapy) even lower the odds further and if so what would those odds be ? Are there any side affects to taking these drugs on a daily basis ? If this would lower the odds much further – which one would you recommend and at what dosage ?

3. I don’t suppose having had chicken pox as a child protects me in any way from contracting HSV1 ?

Thanks for any info that can help me make a more educated decision.

Ozworth

[Terri Warren]

Having chicken pox will in no way protect you against getting HSV 1, no.
Unfortunately, we don’t have transmission rates for people who have HSV 1 – either to someone else’s mouth or to someone else’s genitals. This is a very frequently asked question, though, not only you want to know the answer.

I will tell you that the pictures of HSV 1 usually shown on the internet are NOT typical presentations but terrible ones. Some people, with first infection, both genitally and orally will get multiple lesions, true. However, if a person knows that they are at risk for acquiring a new infection and act very quickly to obtain antiviral medication (or better yet, have it at the ready to use, just in case, then the outbreak can be limited substantially. Most people with oral HSV 1 have between 3-5 cold sores per year (genitally less than one per year). And YES, daily therapy by her, in this case, can reduce the frequency of cold sores appearing and likely also reduces the frequency of viral shedding. I, for example, have had cold sores since I was a child, and really don’t like them at all. So I take daily antiviral therapy and have reduced the frequency of getting them by probably 90%. When I feel one coming on anyway, I just up my medicine some and can stop them in their tracks, not going on to a full blown cold sore. Though research suggests that the medicine is not as effective for HSV 1 as it is for HSV 2, the difference is not all that significant at all.

I think if you are involved with a person who has HSV 1 orally and want to take a small measure of risk of getting HSV 1, it would be helpful if she was on daily therapy (acyclovir 400 mg twice a day) and somehow, either from her or from your own health care provider, have some antiviral therapy on hand in case you do contract herpes so you could start using it right away. Most people do not see side effects from taking this medicine. Avoiding contact during outbreaks and at the very start of one is certainly helpful, yes. The reality is that people can also shed virus between outbreaks.

Terri

[Ozworth]

Thanks for the info Terri. Quick follow up question on Acyclovir and Lysine below.

1. I would suppose me taking Acyclovir daily would not benefit me in anyway ? Would it decrease the likelihood of me contracting ?
2. Would it be beneficial for her to take Dynamiclear Combined Lysine Formula daily to decrease the viral load during shedding periods ? Would it benefit me in anyway to take Lysine daily to decrease likelihood of contracting ?
3. What dosage of Acyclovir is recommended (you said you up your dosage..) if you feel one coming on and want to prevent full outbreak ?

Thanks

[Terri Warren]

1. No, that would not benefit you
2. NO and NO
3. Well, I have the luxury of having an insurance that covers valacyclovir (valtrex) so I up mine to 1 gram three times a day, but if I was using acyclovir, I would probably do 800 mg three times a day or even four times a day for a day or two. If the medicine is going to stop it, it would likely stop it the first few days of taking the medicine. These are not FDA approved doses, these are just the doses I use.

Terri

[Ozworth]

Sorry – one more follow-up. What is the dosage of Valtrex you take daily now ?

Thanks

[Terri Warren]

500 mg once a day, at the same time each day

Terri

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