Regarding GHSV-1 g-g, g-o transmission, and antivirals

[fairvale]

My partner (male) has GHSV-1 (only one outbreak, doctor didn’t swab test but sight-confirmed herpes, and then later on a blood he was confirmed positive for HSV-1), and I am (to best of my knowledge, and after testing) negative for both types. The single breakout, which was extremely mild, occurred over a year ago. We have been using condoms since then, as the symptoms he experienced were on his penis (I’m assuming this is the primary area for shedding I should be concerned about, unless shedding can migrate to other locations). He would like to stop using condoms.
What are the transmission rates for genital-genital and genital-oral contact for GHSV-1 (I believe it sheds on 3-5% of days) without condom use or antivirals, please?
Also, does it make sense to potentially see if he can take antivirals (to reduce risk in lieu of condoms), even though he hasn’t had any subsequent outbreaks, just to lower shedding rates? (although he may be shedding less after a year?)
Thank you in advance.

[Terri Warren]

We do not have transmission rates for genital HSV 1 but we know it is very low.
Once a person has been infected with HSV 1 genitally for 2 years, they shed virus on approximately four days out of the year. So you can see the risk is low. Taking antiviral medication would reduce that even more.

Terri

[fairvale]

Thank you for your reply. Oh, I see… I thought the shedding rate was lowered to 4 days a year just one year post-infection.
Would you recommend someone like my partner (GHSV-1, only one outbreak almost two years ago) taking antivirals to lower the risk of spreading to me?
Am I at any greater risk of contracting HSV (GHSV-1) if I have unprotected oral sex with him versus unprotected vaginal sex?

• This reply was modified 1 year, 4 months ago by fairvale.

[Terri Warren]

We do have shedding data – we just don’t have transmission data. They are different. Not all shedding results in transmission. The shedding rate, after two years of having genital HSV 1, is about 4 days out of the year – 1.3% of days.
The risk is probably about the same for intercourse or oral sex.
If you are really concerned about HSV 1 and test negative yourself, then daily suppression may have help ease your mind. And it will likely have some impact on transmission.

Terri

[fairvale]

Thank you so much Terri!
Do you think it makes sense for my partner to take suppressive antivirals for a few months until we hit the two year mark, or am I being too concerned about this? (We are about 20 months out from his first and only outbreak)

[Terri Warren]

Sure, if it makes both of your feel more comfortable, there is no down side to taking antiviral medication.

Terri

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