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Nycres

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Nycres

Hey everyone,

I'm new to the site and wanted to introduce myself. Two weeks ago I had my second outbreak of genital hsv-1. It started as just really itchy skin and then it turned into a big red patchy (painful) cluster in the pubic area.  My first outbreak was four years ago and have never had any symptoms until now. When I got bloodwork done it came back negative the first time. Throughout the years I would get blood test taken and they always came back negative, but deep down I knew It had to be herpes. I know exactly what caused it, stress. Working late, poor diet, little exercise and cramming for a professional examination. Currently on valtrex for five days, and taking lysine supplements. 

Lastly, I recently met a girl and feel like I should tell her. I've been avoiding her for two weeks. I may say something along the lines of "90% of population has it" or "ever get a pimple on your lip?" I'm in no way ashamed of what is essentially a harmless skin condition. Once the outbreak fully goes away what are the chances I spread genital HSV-1? 

Thanks for letting me rant! The only person I can talk to about this is my ex but she's in Europe. 

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WilsoInAus

When you say pubic area, whereabouts are you referring to?

Did you have a swab taken of the first outbreak as well as a blood test?

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Nycres

Directly below your belly button right before my genitals. Dead center.  The first time I did not. The second time, yes and It came back positive for hsv-1. 

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WilsoInAus

Sorry, which swab taken from where came back positive for HSV-1? Where was the first outbreak?

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Nycres

Swab from the pubic region came back positive. Doctor popped a white head and used that as a sample.  The first time, 4 years ago, it was all over my penis and so painful. 

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WilsoInAus

If we are talking a swab that has been correctly typed for HSV-1, then there is little question you have genital HSV-1.

My only thinking was that this current outbreak may not have been herpetic, but you have confirmed that it is via a swab.

Transmitting genital HSV-1 is very low risk absent an outbreak. Shedding may occur as little as 5-15 days a year. If your partner already has HSV-1, then this is zero or something approaching it. It is not known what the transmission rates to a female are, but probably of the order 1-2% per annum no condoms and antivirals. Condoms provide a female with good protection from a male given shedding occurs more often from the penis if this was the original entry site in particular.

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Blahdittilyblah
2 hours ago, WilsoInAus said:

If we are talking a swab that has been correctly typed for HSV-1, then there is little question you have genital HSV-1.

My only thinking was that this current outbreak may not have been herpetic, but you have confirmed that it is via a swab.

Transmitting genital HSV-1 is very low risk absent an outbreak. Shedding may occur as little as 5-15 days a year. If your partner already has HSV-1, then this is zero or something approaching it. It is not known what the transmission rates to a female are, but probably of the order 1-2% per annum no condoms and antivirals. Condoms provide a female with good protection from a male given shedding occurs more often from the penis if this was the original entry site in particular.

Not trying to hijack the original thread but Wilson could you briefly explain the 5-15 day range you said it's for the entire year. What would be that rate for HSV2?

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WilsoInAus

Shedding is an interesting concept. It is likely that the virus blooms to the surface and dissipates very quickly. Shedding for study purposes is defined as being identified by a daily swab I believe at about the same time each day. In theory this could miss some shedding, although the PCR test is so sensitive I believe it would pick up the virus for hours after it is inactive on the skin's surface. The viral copy count is also usually not assessed. Hence what does shedding actually mean is a fair question. I have always stated that it is important to look at the actual asymptomatic transmission rates for the practical outcome of shedding. The study of shedding post a vaccine for example may not be relevant and is inferior to transmission rates post a vaccine which is my point about not getting too carried away with why shedding is not explicitly studied at present. What we need is a study of the transmission probability given viral copy count. 

Terri Warren summarises the shedding rates in her herpes handbook. A range is provided representing the range of study results that have gone into her conclusions. The average may not be the centre of the range.

HSV-2 is quote (page 17) as occurring on 15-30% of days, that's a range of say 55 to 110 days per annum. 

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