First Year HSV

[Reilly123]

Hi All,

I understand that transmission odds are "significantly" greater in the first year of acquiring HSV-2, but does anyone have the stats/differences on that as compared to subsequent years? Also, would daily valacyclovir reduce the transmission odds by 50% in the first year as well? I am a female by the way, with a partner who is aware of my status, but is negative. He is completely unconcerned about the risks, but that makes only one of us--I am mortified by the idea of potentially giving this to him.

I have been relatively asymptomatic (no real sores or lesions, just a little irritation, like yeast without the discharge) but had strongly positive IGG results for both HSV-1 and 2 recently. Due to the mild presentation, I suppose I can't be certain that this is, in fact, a first year infection, but I'm erring on the side of caution. (Just because my symptoms have been negligible doesn't mean my partner will be so lucky, right?)

My hope is that the often quoted transmission rate of "4% no meds or condoms/2% meds only / 1%meds and condoms" per year of sex is still in the ball park for us newly diagnosed gals. If not, does anyone have an idea as to what the odds jump to?

Thanks

[Reilly123]

Thanks so much! That's very helpful and reassuring. Being better educated about all of this really does help put it all into much better perspective. Thanks again!

[gracefromHHP]

well yes but even at that, it's very low risk of transmission overall.

in the valtrex and reduction in transmission study, lots of stats were obtained but overall the couples that transmitted were low in general. When you actually remember to take your medication every single day, the risk of transmission to a partner goes even lower yet. Unfortunately a good percentage of the people who transmitted the infection to their partners, didn't remember to take their daily valtrex at least 80% of the time. ( I know the article you referenced wasn't referring to that study but it was a well done study and far bigger than the 2 studies referenced in that section you are referring to )  Precautions really do work and help to keep even the higher risk of transmission during the first year of infection as low as possible :)

[Reilly123]

Thanks so much for the help and encouraging words. I saw a wonderful, calming, reassuring Dr.a couple of days ago that started me on the once daily valacyclovir--So far, so good. No noticeable side effects to report, and my insurance covers it for for only $20/90 day supply, so I'm thrilled. (Three cheers for generics!)

On a different note, I am including a piece from an article (one of the ones I read that made me concerned about being much more contagious in the first two-years. Perhaps it's out-dated or inaccurate? Hopefully? Here's the pertinent quote:
"Valacyclovir-treated persons who had genital herpes for less than 2 years were nearly 3 times more likely to transmit than those who had genital herpes for more than 2 years." I suppose that "three times more likely" would still bring female to male transmission rates to around 6%/year with Valtrex and w/o condoms, right?

If you're interested, the entire article link is here:
http://www.medscape.org/viewarticle/472427_2

Thanks so much for all you do here. Any insight would be appreciated!

[gracefromHHP]

that's good that you were sure of your test results!

no, the rates of infection to a male partner do not increase for the first year of infection.

if you have less than 9 ob's a year, the 500mg daily dose is fine. You really don't get a lot more bang for your buck with the higher dose so it's not worth taking if you aren't having very frequent recurrences.

[Reilly123]

Hi Grace,

Thanks for responding. I'd done enough pretesting homework to assure the quality of the tests I received. They were the HerpeSelect IGg with both HSV-1 and HSV-2, each resulting in levels >5.00. :( It was a sad and shocking day, to be sure. I've still never had an oral cold sore or any classic lesion on my nether regions, so I suppose I can count myself fortunate as far as HSV goes--so far anyway.
Since there is no way to know for sure how long I've had this virus, I'm just trying to err on the side of caution with regards to my infectivity of a discordant partner and assuming it's new. (Newly discovered, at least) I'd just read that this virus is much more active in the first 6 months -2 years, and I wondered to what degree? Does a 4%/year potentially jump to a 20%/year chance female to male if its the first year of infection?
To complicate matters, recognizing outbreaks is proving challenging. I'll get a vague uncomfortable sensation, but I think I'm just more hyper- aware of the area than normal, with some slight itching and redness (probably from me investigating and itching). I swear I think I make matters worse because I'm inspecting every little spot with a flashlight and mirror, trying to determine what an "outbreak" is or isn't. I'm trying to learn my body response because I feel like it's potentially more dangerous to my partner if I can't recognize ob's accurately.
Maybe the once daily valacyclovir will help alleviate some of this anxiety. Any knew opinions on taking 500mg daily vs.1 gm daily?
Thanks!

[gracefromHHP]

I'll gladly take a look at your test results if you want to post them here so that we can be sure that you were properly tested and don't need further confirmatory testing. You can just post the numeric results here - e.g. hsv1 igg 7.9 and hsv2 igg 4.9 or whatever they are.

if you've never been tested before, no way to know when you were infected.

yes, the stats we quote all still apply to the first year of infection. Most of the time the studies done include almost all newly infected patients so they are including the more actively times of shedding the virus.

grace