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Viral Shedding
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Viral Shedding

I am 43 years old otherwise healthy male and have had genital herpes for almost 22 years now.

When I was diagnosed with this disease in 1986 I was told in a nutshell, no sores - no problem (that is in the absence of ALL the stages associated with the disease of course) and I had no reason to think otherwise that is until yesterday.

I have always been forthcoming about the disease and informed every partner prior to engaging in sexual activity, and went so far as to suggest they talk to their family doctor (before the internet) and/or research the disease, and in the beginning always used condoms. I say that because every partner at some point along the way felt confortable that we stopped using them > when there were no sores present.

And with that said, to the best of my knowledge only 1 partner ever became infected after I was diagnosed and it was towards the end of our 2nd year together when she made a conscious decision. I had a sore, I informed her, we did not have any condoms, she said she didn't care that she loved me and wanted to spend the rest of her life with me.

I should also mention I "usually" have 2-3 outbreaks a year and they are mild, the last outbreak was February 2007, I also started once daily Valtrex in March 2007. I went to my family doctor after seeing the commercials on TV and asked for it because I understood it could prevent recurrences and since I was coming out of a long term relationship it made sense. Surprisingly I was not given any detailed information about the drug or "new" information about the disease, I can only assume because I have had genital herpes for so long that my doctor didn't think it was necessary?

I have been with my current girlfriend for 6 months, as always I informd my partner I was a sufferer and in the very beginning we used condoms, soon after we stopped because she believed (as I always have) no sores - no problem that was until yesterday.
While she was at the Health Clinic yesterday dropping off water samples (we have E coli and coliform in our well) she picked up a booklet about genital herpes and started reading it and refers to something called "viral shedding", so of course she is now questioning why I didn't tell her and I think she feels I betrayed her which I did not.  She is also convinced she has the disease because when we make love she itches for a couple days afterwards. She is going to speak to her family doctor about getting tested, so we won't know for certain until then. I personally suspect it has to do with changes in her vagina and vaginal itching since she has been menapausal for 7 years now and has not had a period for 3 years.

In the interim I am looking for specific information about "viral shedding" as it applies to genital herpse that is not biased so to speak, I say that because the booklet my girlfriend brought home was produced by GlaxoSmithCline and most of the stuff I am finding on the internet seems to be driven by them in that alot of the websites I am going on are using their publication information.
It is also my understanding that viral shedding/genital herpes really only came to the forefront about 3 years ago, how is that ?


Regards
Stephen

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101028_tn?1348750963
Hey Stephen...no need to get the conspiracy theories out for when it comes to viral shedding and GSK - it's not them just trying to sell their product - it's a matter of they have the $$$ to get the word out there about how to best protect your partner.  TONS of research on viral shedding both right before an ob, during an ob, after ob's and in between obvious ob's ( and it's been WAY longer than just 3 years too ).  It also just so happens that GSK sponsored the valtrex and reduction in transmission study several years ago so they get the bragging rights for reducing transmission to a partner which is how all their commercials nowadays approach it ( I have genital herpes, my partner doesn't etc ).

So were you told about viral shedding 22 years ago? Heck no you were probably diagnosed the same way I was - a dirty look, perhaps a pamphlet, told to wear a condom and/or keep it in your pants and sent out the door.  We really were told back then just avoid sex during obvious symptoms and everything will be A ok.  And since you haven't had any unusual issues with your herpes since then you've really had no reason to pick up a pamphlet and get updated or seek out a website.  The well adjusted folks with herpes - usually don't stumble upon these sorts of sites because it just never occurs to them to do so in general.  I myself had had hsv2 for over 10 years before I ever stumbled upon any herpes websites and that was only because I was looking for a dating site for folks with herpes!!  Obviously I've come a long way since then :D

As for your gf - just itching for a few days after sex - even if she does have hsv2 - isn't likely to be related.  Sounds more like a lack of lube issue. If she's post - menopausal it could even be a thinning of the genital skin which can be easily treated with applications of estrogen cream externally.  

so with you two avoiding sex whenever you have an obvious genital lesion and you being on daily suppressive therapy - your gf is about 95-96% likely each year NOT to contract hsv2 from you.  If someone told her she was 95-96% likely to be the big winner in the powerball tonight I'm betting she'd still risk playing it right?  

grace

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Avatar_n_tn
Hi

I only heard of viral shedding yesterday when my gf came home with the GSK book.

I asked my family doctor (after I spoke to gf yesterday morning) and she indicated it really only came to the forefront 3 years ago as far as she knew anyway.

Where are you getting the Stats from ?????? I would like to print these off and or send her to the site.

so with you two avoiding sex whenever you have an obvious genital lesion and you being on daily suppressive therapy - your gf is about 95-96% likely each year NOT to contract hsv2 from you.  If someone told her she was 95-96% likely to be the big winner in the powerball tonight I'm betting she'd still risk playing it right?  



Thank you
Stephen
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101028_tn?1348750963
Those stats come from the valtrex and reduction in transmission study that was published in the new england journal of medicine - jan 1, 2004 issue.  You can register online for free with them and download it to read yourself if you want.  Even if some of the info seems like greek - the tables alone are very interesting.  

The herpes handbook at www.westoverheights.com has terrific info as does the herpes info at www.ashstd.org. Both are reputible sites and have been around for a very long time.

They've known about shedding from the early 90's ( if not before ) - evidently your doctor, like many doctors, just wasn't aware of it herself even.

grace
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Avatar_n_tn
Thanks

I just registered to the NEJM.

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Avatar_n_tn
I sent an email to GSK asking for a breakdown of the stats/information in plain language.
I recieved a response to ask my health care professional, talk about passing the buck.
They manufacture the product, have done and/or paid for the research and they expect my health care professional to have this information at their disposal, fingertips.



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Avatar_f_tn
What information did you want "broken down?" Glaxo is right that most family practitioners probably are aware that Valtrex is the gold standard for preventing transmission and/or decreasing/minimizing outbreaks.

I'm no mouthpiece for the drug companies (they don't win any points from me for their corrupt practices, as far as I'm concerned), but the Valtrex stuff probably *is* common knowledge to most health care providers.

Most practitioners probably haven't taken the time to read the study. They get the NEJM, look for articles that are meaningful for their own patient population, and probably read the results of the studies and the recs, and that's it. To be honest, most docs probably aren't too interested in a lot of the specifics.
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101028_tn?1348750963
Read the last section of the study and look at the tables in it. That's the info you really need to know and it's less confusing than some of the other info. If you have any questions - just ask :)

grace
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