Asymptomatic herpes shedding

How common is asymptomatic herpes shedding?

Recent research data suggest that herpes shedding is a more common phenomenon than previously thought. [1, 3] Shedding Patterns of Genital Herpes Simplex Virus Infections
https://jamanetwork.com/journals/jama/fullarticle/2797620
Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students
https://pubmed.ncbi.nlm.nih.gov/14520181/

The commonality of asymptomatic herpes shedding depends on many factors, varying from individual to individual and depending on host/virus interaction.

It depends on the:

No correlation was noticed between age, gender, and frequency of asymptomatic herpes shedding.

However, the Caucasian race has a higher shedding rate than other races.

Can I tell how often I shed the virus?

Only if researchers studied your particular case, and it cannot be done in everyday practice.

What is the test that can establish asymptomatic herpes shedding?

In the past, asymptomatic herpes shedding was determined by viral culture. Recently, researchers started using PCR, which can amplify DNA in the smallest sample size. So, the rate of HSV detection is 3.5 times higher with the PCR method. [1, 3] Shedding Patterns of Genital Herpes Simplex Virus Infections
https://jamanetwork.com/journals/jama/fullarticle/2797620
Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students
https://pubmed.ncbi.nlm.nih.gov/14520181/

How long does average “silent” herpes shedding last?

About 75 % of asymptomatic herpes-shedding episodes last for a day. The median shedding episode duration is about 13 hours.

When is the asymptomatic herpes shedding is highest?

The HSV shedding is highest in the first year after infection and rapidly declines after that.

This is true for both virus types:

For example, in one study, asymptomatic HSV-2 However, herpes shedding happened even two decades later and remained relatively stable at 11 % of days a year.

What is the area where the silent virus is shedding?

Virus shedding occurs in the area where herpes stays dormant. For example, if you have herpes genitally, it remains dormant in the sacral ganglia, and the entire area innervated by the sacral ganglia—that is, the whole of genital and pelvic skin areas such as vulva, vagina, cervix, penile skin, urethra, anal area, urine, semen, and feces —may shed the virus.

What determines the chance of transmission?

The chance of herpes transmission with asymptomatic herpes shedding depends on the following:

What reduces the herpes shedding?

Suppressive antiviral medication will reduce not only the number of outbreaks but viral shedding as well.

Antiviral medication such as acyclovir, valacyclovir, and famciclovir decreases genital shedding by 70-80%.

It decreases the frequency of the shedding as well.

However, even a high dose of suppressive medication does not eliminate the shedding, and breakthrough shedding still occurs.

Is the Herpes shedding different for different herpes types?

HSV reactivation depends on both the herpes type and the anatomic area site in which it is affected.

HSV-1 prefers the oral area, and HSV-2 prefers the genital region. If the preferred location is affected, the chance of reactivation and shedding is higher.

HSV-1 virus shedding from the oral area is constant, about 3.2% of the days a year. [3] Viral Shedding 1 Year Following First-Episode Genital HSV-1 Infection https://jamanetwork.com/journals/jama/fullarticle/2797619

Genital HSV-1 virus shedding is about 1.3 % of the days a year. [3] Viral Shedding 1 Year Following First-Episode Genital HSV-1 Infection https://jamanetwork.com/journals/jama/fullarticle/2797619

HSV-2 virus shedding from the genital area is about 10.6% days a year [1] Shedding Patterns of Genital Herpes Simplex Virus Infections https://jamanetwork.com/journals/jama/fullarticle/2797620

Does herpes shedding have a smell?

The smell is not one of the tell-tell signs of herpes shedding.