Genital HSV-1 viral shedding

[HMcM]

Is there a correlation between the frequency of outbreaks and viral shedding? For example, if someone gets multiple outbreaks per year does that mean they are asymptomatically shedding more often than the person who experiences, say, 1 outbreak per year? I know genital HSV-1 is less well studied than genital HSV-2 however, any information on this topic would be appreciated.

I am wondering about this as I was diagnosed two months ago with genital HSV-1. I have not had a recurrence yet. (I am hoping I am one of the ~40% who will never get one!) We are planning for another baby next year. If I am lucky, and someone who never gets a recurrence, I am wondering about the chances of shedding the virus- and thus exposing the baby- during delivery. (I am planning to be on Valtrex for the last months of pregnancy regardless).
Thank you for your insights!

[gracefromHHP]

yep, it's usually way harder to wrap your mind around the "idea" of having herpes than it is living with it.   You also have to stop believing there is a social stigma around std's before you can accept that there is none to what is going on with yourself. They are just germs like the common cold, puke/poop virus and the flu - just for some reason folks still think if it came from sex it must be shameful.  we don't think twice when someone at work is sick with a cold and then a few days later we get it but we get naked, exchange body fluids and play tonsil hockey with someone and then act surprised when we get sick somehow from it. makes no sense to me at all!

grace

[HMcM]

Thank you for your reply. I think deep down I know that this "thing" shouldn't prevent us from  having another baby... I guess I just needed to hear it from an expert!

Your response makes perfect sense to me and you are right, I don't know anyone who has ever passed on HSV to a child during labor/ delivery and I also don't know anyone who would avoid getting pregnant for fear of a birth defect.

The more research I do and the more time I've had to think about my own positive status, the more I realize how psychologically difficult this virus can be. My own OB/GYN (who I trust and have had through pregnancy!) didn't think my diagnosis was a "big deal" at all. Yet, I am still obsessing about it... it's really the social stigma of it that is the culprit here...

Sorry to ramble and thank you again for your help!

[gracefromHHP]

actually the studies we have show that daily suppressive therapy didn't really affect transmission rates, it just affected the odds of having a lesion at the time of delivery or not.  The rates of transmission are so incredibly small in general that it wasn't a significant effect on the rates of transmission.  

It's not irresponsible to get pregnant at all with having genital herpes!  1 out of every 4 women of child bearing age on average has hsv2 genitally - how many folks do you know have passed on hsv2 to their children during birth?  the overall risk of a birth defect in general is 3% -  how many folks do you know  who in general say they don't want to get pregnant because of the risk of a birth defects?  

[HMcM]

Thank you for your reply. Assuming I do not have obvious lesions at the time of delivery, will taking suppressive therapy lower the risk of transmission even further? I am trying to understand how worried I should be about this. Is it considered "safe" for someone in my position to get pregnant? Or is it an irresponsible decision since there is a risk of harming the baby?

My OB didn't think this was a "big deal" for future pregnancies (he just said I would go on Valtrex and get a C-section if there was an outbreak). However, my concern is the asymptomatic shedding when there is no outbreak.

[gracefromHHP]

there is little correlation between the number of ob's and the frequency of shedding actually.  

hsv1 doesn't shed much genitally.   the risk of transmitting to your baby during delivery is very low in general.  less than 1% if you don't have any obvious lesions at the time of the delivery.

grace