Help with understanding shedding data

[LucasA]

Hello people,

I found the following article online:

https://www.ncbi.nlm.nih.gov/pubmed/7643884?dopt=Abstract

It is a research from expert Anna Wald where it says "During a median follow-up of 105 days, subclinical shedding of virus was identified in 36 of 65 women (55 percent) with HSV type 2 (HSV-2), in 16 of 31 women (52 percent) with HSV type 1 (HSV-1) and HSV-2, and in 4 of 14 women (29 percent) with only HSV-1."

 

Does that mean that some people do not shed at all?

If subclinical shedding was identified in 55% of HSV-2 positive women, it sounds like the other 45% did not shed the virus at all.

Is that accurate or am I missing something?

 

[WilsoInAus]

Hey @LucasA what you are reading into the article is correct. However there are a number of considerations. 

The main one being that being an old research study from 1995, cultures were used. This would mean a considerable amount of virus would need to be present for a positive sample.

When PCR became more common in research, which can identify a handful of viral copies, the day on which shedding was detected increased.

Shedding is however only a small part of the story, less than 1/3 of shedding episodes actually carry a viable amount of the virus to infect. 

What is more relevant are the actual transmission chances. This takes into account whether the person is shedding at all during sex, whether there is enough of the virus and whether the host is actually infected. Female to male this is estimated at about 4% chance after a 100 sexual episodes.

[difficultroadahead]

Hi What would the male to female shedding and transmission rates be for GHSV2 using daly valtrex as suppression

 

Edited September 16, 2019 by difficultroadahead
adding content

[WilsoInAus]

2 hours ago, difficultroadahead said:

Hi What would the male to female shedding and transmission rates be for GHSV2 using daly valtrex as suppression

 

With no measures, this risk has been assessed at about 8% per year where the positive male has had the virus for more than 2 years.

If you were infected on your penis, then you have reason to believe that a condom would provide well over a 50% reduction in risk, perhaps as high as a 90% reduction. This is hence the primary measure a male should consider over antivirals.

Antivirals would cut odds in half again, but this is a bit of ‘icing’ for the condom measure.

[blurneworder]

2 hours ago, WilsoInAus said:

With no measures, this risk has been assessed at about 8% per year where the positive male has had the virus for more than 2 years.

If you were infected on your penis, then you have reason to believe that a condom would provide well over a 50% reduction in risk, perhaps as high as a 90% reduction. This is hence the primary measure a male should consider over antivirals.

Antivirals would cut odds in half again, but this is a bit of ‘icing’ for the condom measure.

What about combined genital and oral infection shedding rates?