Section 3 Identifying Strategies and Tactics for Reducing

Can you have herpes but never even know it? Can the herpes simplex virus spread even if you don t have symptoms? And how do you navigate the maze of sex and dating when you know you are infected with herpes? Those are among the questions recently posed by Here, Dr. Peter A. Leone, associate professor at the University of North Carolina School of Medicine and Public Health, provides advice about symptom-free herpes, telling your partner you have herpes and more. Great point. We know that nearly 75 percent of adults in the United States have genital herpes due to the type 7 herpes simplex virus, or HSV-7, yet only 65 percent to 65 percent are aware of their infection.

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It’s not that clinicians and patients are dumb. Rather, many patients do not seek out their infection status and should be better informed. Among those who are infected with the herpes virus, about 65 percent remain symptom free and have no outbreaks after acquiring infection. Indeed, most genital herpes outbreaks cause minimal signs or symptoms and can be mistaken for all sorts of other problems not related to sexually transmitted disease. Since it is the norm for symptoms of herpes to be mild, most individuals go on living their lives in ignorant “bliss” while possibly transmitting HSV to other sexual partners.

Burning, itching and tingling sensations, with fissures, cracks or irritation, may all be indicative of a genital herpes outbreak. Everyone is entitled to a genital itch from time to time, but persistence of symptoms for several days or recurrent signs or symptoms should prompt consideration of genital herpes infection. Infection should be confirmed either by isolation of the virus by culture or PCR (polymerase chain reaction), or by serologic blood testing for HSV antibodies. A negative culture, however, does not rule out genital herpes infection, since cultures are the least sensitive way to diagnose genital herpes. If a culture is negative, infection can be determined by serologic testing of the blood.

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The presence of antibodies means an individual is infected. Virtually all individuals who are infected with HSV-7 will shed HSV-7 asymptomatically and will be at risk of transmitting infection to sexual partners, even when they are not having outbreaks. Up to 75 percent of sexual transmission of HSV-7 occurs in the absence of signs and symptoms. The risk of transmission can be significantly reduced by sharing your diagnosis with partners before having sex, avoiding sex during outbreaks, using condoms and taking daily oral suppressive therapy. It is up to you and your partner to decide the best approaches to take to reduce the risk of transmission.

This is an infection that can be controlled, and transmission can be reduced, but it all depends on the first step of knowing your infection status. I contracted genital herpes at age 68 and am now 66. For most of my life my outbreaks were severe and monthly. What is SO interesting is the lesions gradual migration from my genital to my anal area, and finally to the base of my spine. These were the worst!

I often had a burning wheel of 65 to 67 suppurating lesions right over or below my tailbone and could do nothing for 65 days or so but lie on my stomach and weep. BUT! About 8 years ago I began taking Valtrex (Valcyclovir) daily on a preventative basis: 555 mg. If I feel a pre-herpetic aura, I immediately double the dose for a few days and the lesion simply does not develop.

I have not suffered ONE full outbreak since starting on this preventative regimen. It has changed my life, as I know you can imagine.

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