About two months ago, I was diagnosed with Genital Herpes. Since that initial eruption I have had no recurrences, but I understand they are inevitable. Most articles I've read estimate between 4 to as many as 24 eruptions in a year's time. I've found it to be rather difficult to locate much information about this disease -- and I'm a librarian! Most of what I've read gives the impression that a person afflicted with Genital Herpes becomes more and more aware of when he is actively shedding the virus as time goes by. At this point, I'm clueless. Some sources indicate that one only sheds the virus when sores are present while others say shedding can occur without the afflicted person knowing his virus is active. I've informed my sexual partners of my status, but would like to feel a little more assured that it's alright for me to engage in sexual activity. That brings up a second question... Must I wear a condom whenever I have sex for the rest of my life?
Answer----------------------
"recurrences ... are inevitable."
Generally speaking this is true. The virus stays in the skin and superficial
nerves indefinitely. - I think its DNA gets linked into the DNA of the cells
somehow. You can tell I'm a family doc not a molecular biologist here. -
The immune system, especially the cells attacked by the AIDS virus, the T
cells, generally keeps the virus from expressing itself as itchy sores.
However, with the immunity wanes, as during emotional stress, lack of sleep,
poor nutrition, treatment with certain drugs, or HIV infection, then the
sores can return.
"one only sheds the virus when sores are present" vs. "shedding can occur without the afflicted person knowing his [or her] virus is active" I am not an expert on this. I do know that obstetricians generally agree that a caesarian section is needed only during active outbreaks of herpes. My understanding is that only when there are active lesions is there a practical concern about giving the virus to a sexual partner.
"Must I wear a condom whenever I have sex for the rest of my life?" Unless you are trying to get a woman pregnant, YES, but not for the reason you think. I am more worried about your health than your sexual partners. Since you have had sex with someone who gave you herpes, you could also contract other sexually transmitted diseases. If you had come to see me, I would have strongly recommended blood testing for syphilis and HIV and maybe for hepatitis B and C. I would have also done urethral swabs, i.e. stuck tiny cotton swabs into the penis, for chlamydia and gonorrhea.
--
Paul Hunter, M.D.
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