Chances of Passing on HSV1 via Anal Sex (Male to Male)

[Mick1981]

Hi,

I am a gay male and I was diagnosed with Genital HSV1 in April of this year.

I got my first outbreak 2 days after reciving oral sex. My first outbreak was 1 sore that blistered just below the head of my penis. I took Valtrex and it cleared up about 3-5 days later.

I want to know what are the true chances of spreading it to another person via reciving anal sex

I haven't had an outbreak since my first in April 2009 and the doctor has given me a box of 30 Valtrex with 5 repeats incase I need it... here in Australia we are fortunate that the government actually pays for a large amount of our prescription medication so a box of 30 Valtrex is only $30 at the counter here, the government automatically pays the other $120.  So cause of cost I decided to now go on supression instead, so i take a 500mg Valtrex Tablet a day.

I did not take anything from when the symptoms cleared in April to when i started daily supression on 24th June.  I did not go on supression cause i had another outbreak but only cause I heard it will reduce viral shedding.

My question is... I have heard of Viral Shedding of the virus, but how large is the area of the viral shedding??? If my outbreak involved 1 sore on the head of my penis, i am betting that if i have another one it will be the same if not less severe as I have heard.. will that mean i will be viral shedding in that spot?? so if we have anal sex with me receiving, as it is far from the area of the outbreak is there a chance he will still get it, even with no outbreak??

After talking about it, we did have sex about 7 days ago and he has not shown any signs of an outbreak since then... also I am having no symptoms at the moment or having an outbreak as there is no tingle, redness or sores, and we showered after sex as I read that it would help.

Even though the symptoms have not come back, is it wise to stay on suppression therapy even though I am yet to have another outbreak, or should I just wait and see if and when I have another one and go from there? My doctor was reluctant the put me on suppression as his view was that HSV1 has a low chance of coming back as it is outside it's home territory, however I am worried about the size of the viral shedding.

Since I have read that you are most at risk of passing it on in the first year, am i wise to stay on supression for a year and then go from there??  While on supression does your imune system still have the ability to work on it's own antibodies?? or when i go off supressive will it be a bit of a shock to my bosy as i'm not giving it the chance to fight it on it's own??

If he has had a coldsore at some point in his life, what would be the chances of him getting HSV1 again but in the genitals?  or would his body have enough anti virals to fight a new infection?

I am taking Lysine supplements daily too and trying to keep away from stress and other factors, also making sure I get enough vitimins daily.

Thank you so much for your help.. as you can tell i am quite scared about this and haven't had a goodtime dealing with this... I like every single other person wishes they had a cure or somthing that supressed the virus 100%.  Hopefully one day they will crack it.  Fingers crossed now that Valtrex is about to go generic, GSK come out with some new super drug :-) One could hope.

[Mick1981]

Thanks Grace :-)

I have hope that there will be a cure for this.. I read on Science Daily how many breakthroughs have come out in 2009 alone! Seems promising that they are going to crack it one day.  Seems like they recently found out how it comes in and out of latency...

I don't know if i am allowed to post the link... but if anyone is interested in seeing what advancements have been found.. it's at:

http://www.sciencedaily.com/news/health_medicine/herpes/  

Worth the read... especially the part of finding the protein that keeps it latent in microRNA

[gracefromHHP]

You should be more surprised if you do have a recurrence, not surprised that you haven't :)

Your partner loves you and doesn't give a hoot about this. If it's the only partner you've been with since this happened then odds are he already has it.  

Worry about things like how you'll manage to save enough money to retire someday, not your genital herpes :)

grace

[Mick1981]

Hey Grace,

I had a swab test done when I had my first outbreak.. the test came back HSV1 positive.  So yes it was typed so I know it is HSV1 which is prob why the doctor told me that suppressive is not recommended and down played it as a massive deal and reassured me that HSV is common.

It is more the emotional and mental side of it that is killing me the most.  I just can't seem to get over it and accept it fully.  I have been reading on the net especially on sites like sciencedaily and see that especially just this year so many new break throughs have been found... so I am hoping especially with the patent on Valtrex ending that we will have somthing soon in the next 5-10 years.  One can only hope.

I am just so paranoid I am going to have another outbreak and it is constantly on my mind but as i am still to have another one, i dunno what i am looking out for...  I am the same as everyone in saying that if only i knew what i know know back then about HSV and i prob would not have got it :-(

[gracefromHHP]

Your partner definitely needs tested if he hasn't already.  The rates of hsv infection in gay males are very high so knowing his status is important.  If he has hsv1, he isn't likely to contract it from you genitally - just avoid sex during obvious genital symptoms to err on the side of caution.  Have you  been with this partner for awhile?  Also with your own testing, the culture wasn't typed, just + for hsv and you are assuming hsv1?

I think you are confusing hsv1 and hsv2 when you say you are surprised you aren't getting symptoms more often. For hsv1 genitally, about 1/2 of folks never get another genital ob. Of those who do, the average is 1 additional ob the first year and then 1 ob every other year after that.  Only a small percentage of folks who have hsv1 genitally get ob's more often.  

grace

[Mick1981]

Hey Grace,

His opinion is, if i get it i get it... and was saying that since it is HSV1 then it shouldnt be as bad as HSV2.  I dunno I am still worried about passing it on, but the info above made me feel better knowing that even though I have it and have accepted this... atleast I get it the way that is supposed to cause the least issues and that is genital HSV1 as opposed to Genital HSV2 which I have read bothers people alot more.

It is odd as I had the first one in April and still nothing.. I read on these boards about people who get outbreaks once a month and more... I still dont know what to look out for when an outbreak is coming on so i know to start taking Valtrex... is it supposed to be a tingle or a strong pain, will i know that it is happening..

I feel better after reading Petals post that she has only had 2 and that is it... It was odd to read that in her first OB she had 20+ sores... with me I had just 1 sore in my initial OB and it was about the size of a cutip... not sure if that means that maybe my body reacted to it well if that is all I had... It did last 2 weeks, but only cause it took me a week to see a doctor and get Valtrex, after i got Valtrex it lasted another 3-4 days and it was healed.

So if he does get a blood test and it comes up HSV1 positive, does that mean his chances of getting HSV1 genitally is low?

[gracefromHHP]

Fanta is correct - valtrex stops further replication of the virus after it already started to reactivate. your body started making protective antibodies against hsv from the moment you were infected. Taking suppressive therapy didn't affect that at all.

Sounds like you are doing a little better with all of this now that you've had some better info about it?   How's your partner feel about it all?

grace

[petal130]

I have genital HSV1 as well, and I do not take suppressive therapy. Partly that is because my partner has oral HSV1 already. But, even were I in a relationship with someone who was herpes negative, I don't know that I'd take it suppressively.

Yes, the virus sheds very little, and folks who have genital HSV1 tend to have 1 or 2 outbreaks the first year, and then maybe one every other year after that. I personally can say that my primary outbreak was last September (awful!), and then I had another this past April, and it was not bad at all. As soon as I had symptoms (only a few lesions as opposed to the 20+ I had with my initial), I took Valtrex and it cleared in 2-3 days.

I would say that depending on the relationship your in will really determine what path you choose. If you're not in any sexual relationship, you may want to forgo it and try not to worry about another outbreak. And then if you are in a relationship, your partner can find out their herpes status. The majority of adults have oral HSV1, and that would provide significant protection from them getting it orally. And even then, you could just use condoms if that person was herpes negative.

I have to say, I never ever worry about it. I'm hoping now that I've had my 2 token outbreaks in the first year :-)  that I won't have another for a long while! And if I do, I have my Valtrex on hand to deal with it.

[fanta1]

Hi mick - regarding the valtrex.  It's an anti-viral, not an anti-biotic.  I believe it works by interfering with the viral DNA replication pathway thereby reducing the viral shedding.  Taking the anti-viral shouldn't have any effect on your body's ability to develop its own antibodies.  I hope that helps.

[Mick1981]

Also I decided to stop taking the supression and see how I go as I keep reading on here that HSV1 has a very low chance of coming back.

Is this true, and how many outbreaks should I expect to have in the first year and then subsiquant years??

[Mick1981]

Thanks Grace,

I found out I was positive for HSV1 via a swab test and the lab results came back positive.  I got it from a cold sore so i am guessing that it would have to be HSV1.

I am not sure if he has had one.. I read the herpes handbook and that said shedding of HSV1 genitally is 3-5% of days evaluated and I was always under the assumption that Valtrex would halve that to 2.5-1.5% or is that only for HSV2?

I have not had another outbreak since my primary one in April 2009 but I am worried that the only reason I havent is cause i'm on suppression so I am scared to stop taking Valtrex.  

If i stop taking it after 1 year which I have heard that is when your reoccuring outbreaks are suposed to lessen, would have my immune system still be able to produce anti bodies while on Valtrex, or is Valtrex like an antibotic where it will effect your immune systems response?

[gracefromHHP]

Sorry your prior questions have been missed - bumping your post back up was the right thing to do!!  Sometimes the board gets very busy and posts fall onto page 2 too quickly to be seen and answered.

So let's start at the very begining - how were you diagnosed as having hsv1 genitally?

Has your partner had a cold sore in the past?  Has your partner been tested for herpes recently?

Hsv1 genitally doesn't reoccur very often and it doesn't shed much at all either.  On average it's shedding about a dozen days or less a year. The odds of having sex on one of those days when you don't have any obvious symptoms are pretty low.  If your partner already has hsv1 orally, the odds of them contracting your hsv1 genitally are incredibly low and not really worth worrying about ( though still avoid sex anytime you have obvious genital symptoms going on  to err on the side of caution of course ).  Even if your partner doesn't have hsv1, odds of them contracting your hsv1 genital infection are still very low.

The provider you spoke to was mistaken about shedding. shedding of genital herpes occurs from the entire anogenital area  , not just where the lesions appear.  So no, anal sex , either giving or receiving, isn't any safer ( though keep in mind from a hsv1 standpoint it's very, very low risk anyways ).  

As far as suppressive therapy for hsv1 genitally, we have no idea if it's worthwhile or not.  Remembering to take a medication daily to help cover shedding over the course of a year is usually more hassle than it's worth though certainly it won't hurt and for some folks the peace of mind is priceless. If your partner has hsv1 already though it's probably not worth it even though you are getting it at a reduced cost.  Condoms also would protect your partner too.  We don't have studies to see if suppressive therapy with valtrex reduces shedding of hsv1 genitally significantly or if it helps to reduce transmission to a partner.  

grace

[Mick1981]

Sorry to ask all these questions, but more interested in knowing the chances of genital-genital HSV1 while on supression meds when you are reciving anal sex.

[Mick1981]

I went and spoke to the doctor... their opinion was that as you viral shed at the site of the break out or where it was, which for me is the head of my penis... receiving anal sex should be low risk as it is far away from the site of where it is living and shedding from... he explained it is like when you have a cold sore if you kissed that persons chin or nose you would be unlikely to get HSV unless you kissed their lip where the break out was.. which made sense..

I don't know if this is true though as I dont know how across STD's the doctor was...

Is there anyone here that has a background in HSV or has personal experience shed (no pun intended :-P) some light on this??  Are there any male-female couples who have engaged in Anal sex and not passed the virus on as that would be the same situation...