Pregnancy Planning with a Partner Who Has HSV-2: What You Need to Know

Pregnancy planning with a partner who has HSV-2?

Hello, Director.
We are planning to have children with my partner.
However, my partner (wife) has HSV-2 and had an outbreak a year ago, with current IgG tests still showing positive results.
If during the pregnancy planning phase, I (the husband) take Acyclovir orally as directed in the instructions to prevent infection in immunocompromised patients until pregnancy is confirmed, will this effectively prevent transmission? Or is it inevitable that having a child will result in transmission regardless?

MIKE, 30~39 year old female. Ask Date: 2021/08/10

Dr. Liao Yaopan reply Family Medicine

Hello, the medications mentioned above are antiviral drugs used for treating viral infections, and they are not intended for preventive use.
In actual clinical practice, their use for prophylaxis is not recommended.
Even if someone has previously been infected, it does not mean they are always infectious at any given time; it depends on whether symptoms are present.
If symptoms do occur, appropriate treatment should be administered.
The situation you are concerned about cannot be guaranteed to not happen 100% of the time, nor does it mean it will definitely occur.
It is advisable to discuss your pregnancy plans further with your obstetrician.
Wishing you all the best and safety.
Please note that online consultations are not equivalent to in-person medical visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2021/08/10

More Info

When planning a pregnancy with a partner who has HSV-2 (Herpes Simplex Virus type 2), it is essential to understand the implications of the virus, its transmission risks, and the preventive measures that can be taken. HSV-2 is primarily transmitted through sexual contact, and while it can be concerning for couples wishing to conceive, there are strategies to minimize the risk of transmission.

Firstly, it is important to note that HSV-2 can remain dormant in the body and may not always be actively shedding the virus. This means that even if your partner has a positive IgG test for HSV-2, it does not necessarily mean that she is currently infectious. The risk of transmission is highest during an active outbreak when sores are present, but it can also occur asymptomatically. Therefore, understanding the timing of outbreaks and taking precautions during those times is crucial.

Regarding the use of antiviral medications, such as acyclovir (the active ingredient in the medication you referred to as "樂威熱素"), these can be effective in reducing the frequency and severity of outbreaks. They can also lower the risk of transmission to a partner. However, it is important to clarify that these medications are not a foolproof method of preventing transmission. While they can significantly reduce the risk, they do not eliminate it entirely. Therefore, relying solely on medication without other preventive measures may not be sufficient.

Here are some key strategies to consider when planning for pregnancy:
1. Consult with Healthcare Providers: It is vital for both partners to discuss their plans with healthcare providers, including obstetricians and infectious disease specialists. They can provide personalized advice based on your partner's health status and history with HSV-2.

2. Suppressive Therapy: If your partner has a history of frequent outbreaks, her doctor may recommend suppressive antiviral therapy. This involves taking antiviral medication daily to reduce the likelihood of outbreaks and asymptomatic viral shedding.

3. Timing of Intercourse: If your partner is aware of her outbreak patterns, it may be beneficial to avoid unprotected intercourse during the days leading up to and during an outbreak. This can help reduce the risk of transmission.

4. Safe Practices: Using condoms can significantly reduce the risk of transmission, even when no symptoms are present. While condoms do not provide complete protection, they can lower the risk of exposure to the virus.

5. Monitoring Symptoms: If your partner experiences any symptoms of an outbreak, such as tingling, itching, or sores, it is advisable to avoid sexual contact until the outbreak has resolved.

6. Discussing with a Fertility Specialist: If you have concerns about transmission and its implications for pregnancy, consulting a fertility specialist may provide additional insights and options.

7. Testing and Awareness: Regular testing for both partners can help monitor the situation. If you have any symptoms or concerns, it is essential to seek medical advice promptly.

In conclusion, while there is a risk of transmission of HSV-2 during pregnancy planning, there are effective strategies to minimize this risk. Open communication with healthcare providers, understanding the nature of the virus, and implementing preventive measures can help you and your partner navigate this situation successfully. Always prioritize safety and health for both partners and any future children.

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