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Dr. Andrew Rynne

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What is the rate of transmission of HSV from female to male?

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Dr. Kulsoom Qureshi

OBGYN

Practicing since :1997

Answered : 1037 Questions

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Posted on Thu, 28 Aug 2014 in Infections
Question: I first contracted HSV 40 years ago from my new husband n 1973. I then got about 2-4 episodes per year for a few years. Then it decreased in frequency to about 1-2 per year. I always get one sore on the inner labia, about in the same area. I have been on Valtrex daily for 10 years. I get one episode about every 1-2 years now that is mild in pain, lasting about 2 days. Hardly noticeable. I have never used a condom, but avoid any sexual contact if I just think I might be coming down with an episode until about 5 days after the last s/s are gone.
My question is this: I read some place that after this many years (40 yrs) the virus is not very virulent. What do you think the rate of transmission is from female to male in someone like me? Considering the length of time I have had it, the Valtrex, the rare episode I have. I know you cannot tell me that it would be safe to not use a condom each time I have sex because I know there is a risk. I know that it is true that a person can be shedding the virus even when they don't have s/s. I just would like to know what you think the chances of me transmitting this are, so my new partner and I can make the decision. I would like you to do a lit search to give me some information I do not already have. Yes, I know to be 100% safe we should use a condom each time. I get that. I want to know what the rate of transmission would be in my particular case.
doctor
Answered by Dr. Kulsoom Qureshi 53 minutes later
Brief Answer:
Some facts.

Detailed Answer:
Hi,
Thanks for consulting us.
I think you understand that, it is impossible to give you exact figures about your infectivity.
Here are some facts that may help you in decision making.
Your risk of transmission is low but you can still infect a person even when asymptomatic for years.
Condoms offer protection but not 100%, and patients with genital herpes can shed virus between outbreaks as well.
Asymptomatic shedding of virus occurs on 8-30% of all days, during these times you are capable of unknowingly passing the virus to your partner.
Antiviral medications can slow the replication of the virus and speed up the healing. Suppressive or continuous therapy can also reduce recurrences.
A healthy lifestyle will help keep your immune system healthy and may reduce recurrences.
Adequate rest, regular exercise, and good nutrition along with avoiding excessive alcohol and smoking, and stress will reduce outbreaks.
Continuous antiviral medication may also reduce asymptomatic shedding of virus in between attacks and decrease the risk of spread to a susceptible partner by 50% as in your case.
Remember, symptomatic and asymptomatic viral shedding become less frequent over time. However, it is possible to transmit the virus years after the initial infection, as there is no cure so far.
Hope I have given you the desired response.
Wish you good health.
Take care.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kulsoom Qureshi 12 minutes later
You basically just told me everything I already know. I mentioned in my first e mail that I already know this information.

I was asking you to do a lit search to tell me, in my particular situation, what the range of rate is. Based on what we know so far in medicine.

Also, is there a gel that help decrease it as well as acting like a lubricant?

doctor
Answered by Dr. Kulsoom Qureshi 6 hours later
Brief Answer:
Other suggestions.

Detailed Answer:
Hi,
Thanks for your question.
I am sorry that I disappointed you, but actually I can't offer a better personalized transmission risk. It is as with other people. However, you may consider PCR-based measurement of asymptomatic shedding rates as a lab evidence for your specific transmission risk.
You may use a water-based lubricant to prevent friction during sex, to reduce irritation of the skin and decrease the risk of outbreak, like K-Y jelly.
Other methods to control the virus spread are vaccines and topical microbicides.
Both are under active research & may become available in the near future.
Best regards.
Take care.



Several different vaccines are in various stages of development. These include vaccines made from proteins on the HSV cell surface, peptides or chains of amino acids, and the DNA of the virus itself. NIAID and GlaxoSmithKline are supporting a large clinical trial in women of an experimental vaccine that may help prevent transmission of genital herpes. The trial is being conducted at more than 35 sites nationwide. For more information, click here Herpevac Trial for Women or go to herpesvaccine.nih.gov.



Topical microbicides, preparations containing microbe-killing compounds, are also in various stages of development and testing. These include gels, creams, or lotions that a woman could insert into the vagina prior to intercourse to prevent infection.Spermicidal foams and jellies may offer additional protection. Spermicides used in contraceptive foams, film and gels kill or neutralize HSV in laboratory tests and may provide some protection when used in the vagina (recommended dose the same as for contraception).
Some contraceptive foams contain ingredients (such as nonoxynol-9) that kill the herpes virus and other STD’s in test tubes.

arrow-paleblue Foams are best used along with condoms, not in place of condoms.





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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