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Positive HSV,asymptomatic,implanon.Contagious?

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Practicing since : 2002
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I have recently started to date someone new and I have told him that I was tested for HSV type II antibodies (specific) and it came back positive-- I believe the results were around 3.0 or so (which I am not sure makes a difference). I was tested for this only to have a general STD screen and had no symptoms. I have continued not to have any symptoms but I do realize I can still be an asymptomatic carrier and still shed the virus. I believe it's been over a year and a half since transmission so it seems likely I may never have an outbreak. Do you know any statistics on how long the first outbreak typically takes? I am in the medical field and I also have done some research on the subject but there seems to be some facts that are a bit inconclusive. I plan on using condoms even though I am also already on Implanon.

The bigger issue seems to be the fact that both me and my partner are scared of transmission through oral sex (mostly vaginal to oral). I am wondering if you can shed some light on this type of transmission or if you know of any studies that show the rate of transmission through this method (type 2 that occurs in the mouth). I know dental dams are available but they are also very cumbersome. It's been hard to find any relevant studies on a people who have never had an outbreak.

Finally, I am curious how most doctors feel about treating an asymptomatic patient with suppressive therapy? I was told that it's not usually recommended in those cases as there can be some severe side effects as well as cost concerns. If you could shed any light on this issue I would be thrilled. Thanks!
Posted Tue, 8 May 2012 in Sexually Transmitted Diseases
Answered by Dr. Robert Galamaga 1 hour later
I will try to give you some good information and recommendations regarding what is going on.

The herpes virus type II is a very tricky type of virus. This is because as you will know the virus can be present in the body without any symptoms. This is in fact usually the case with most of my patients.

The concern of course is transmitting the virus while you are asymptomatic. We know now that this is certainly possible. I treat many patients who have no symptoms with antiviral therapy in order to decrease the possibility they will transmit the virus. This is very safe and not very cost prohibitive.

Regarding transmission of the virus through oral sexual contact. This is something which is nearly impossible to predict but we know that from certain studies that it can happen.

You are correct that there are really no good barrier forms of protection in this sense. If you were my patient in my clinic I would offer you suppressive therapy in order to diminish the likelihood of transmission. Beyond that it would be up to you as far as your comfort level regarding the risk that goes along with this type of intimate contact.

Thank you again for submitting your question. I hope you find my answer to be helpful and informative. If you have any additional concerns I would be happy to address them.


Dr. Robert
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