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Can Genital Herpes Be Asymptomatic And Go Unnoticed?

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Posted on Tue, 17 Jan 2017
Question: Hi Dr.Kakkar,
Additional question:
My girl friend whom we have previously discussed has inactive genital
herpes. Even though she took a antiviral drug when she was sexually
active, she did not take meds when she was not sexually active. This inactivity was for 8 yrs. and since she did not have any outbreaks or flare ups she remained off meds for this entire time with no consequence. After that time lapse, she was in a sexually active long distance relationship for 8 months. The sexual activity was weekly once a month during which time she took antiviral meds.
During this her partner who was herpes free did not contract the disease. When this
relationship ended she returned to and has remained med free. She will resume meds prior to our sexual activity. I think that you recommended daily antiviral pills 1 wk. prior ( kindly confirm or rectify this).
Here is my question. Her doctor has attributed her med free non flare up periods to the fact that she has an extremely strong immune system. does this opinion, combined with her contacting genital herpes several decades ago, have any impact, positive or negative, of my contracting genital herpes from her?
Thank you.
doctor
Answered by Dr. Dr. Kakkar (49 minutes later)
Brief Answer:
Regarding genital herpes

Detailed Answer:
Hello.

Of course both these facts i.e she has a very old infection and extremely rare outbreaks which means strong immunity against genital herpes are points in favour. That means she is less infectious (but not non infectious) as compared to someone with a recently acquired herpes infection and frequent genital outbreaks.
This happens in most individuals i.e the outbreaks become less frequent and milder as the time passes by. Nevertheless, there can be intermittent low grade asymptomatic virus shedding even without clinical episodes. Suppressive therapy with valacyclovir reduces this asymptomatic virus shedding by interfering with viral multiplication and further reduces the chances of transmission even when the person has no clinical episodes. Starting valacyclovir a week prior to starting sexual activity would be a safe measure.

Regards
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Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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Can Genital Herpes Be Asymptomatic And Go Unnoticed?

Brief Answer: Regarding genital herpes Detailed Answer: Hello. Of course both these facts i.e she has a very old infection and extremely rare outbreaks which means strong immunity against genital herpes are points in favour. That means she is less infectious (but not non infectious) as compared to someone with a recently acquired herpes infection and frequent genital outbreaks. This happens in most individuals i.e the outbreaks become less frequent and milder as the time passes by. Nevertheless, there can be intermittent low grade asymptomatic virus shedding even without clinical episodes. Suppressive therapy with valacyclovir reduces this asymptomatic virus shedding by interfering with viral multiplication and further reduces the chances of transmission even when the person has no clinical episodes. Starting valacyclovir a week prior to starting sexual activity would be a safe measure. Regards