[Question #11369] Risk of HSV-1 both orally and genitally?

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15 months ago
I'm male and I received unprotected oral sex briefly (about 1-2 minutes) from a female sex worker who isn't very active, and claimed that she was tested in February and all clean. The oral sex was not vigorous at all, slow and gentle, so not a lot of rubbing (if that's relevant). We then had protected vaginal sex. Afterwards she gave me a quick, single kiss on the lips.

After it was over, we were talking about how we both were tested (IgG blood test) negative for herpes, but she mentioned she had cold sore on her lips once when she was a kid, but in the recent test she was negative for HSV-1. We both went to the same lab for our tests so I have reason to trust the legitimacy of that lab and that she's not lying.

My question is - is it possible that she actually has HSV-1 but the test didn't detect it (I was led to believe that IgG blood tests miss about 30% of infections)? And from my encounter with her as described, what are the chances I could have gotten HSV-1 (both genitally and orally) from her? Many thanks.
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Terri Warren, RN, Nurse Practitioner
15 months ago
Yes, the IgG test for HSV 1 misses 30% of HSV 1 infections compared to the gold standard western blot.  It could have missed it in you as well, of course.
The kiss seems very low risk to me
And if she hasn't had a cold sore since childhood, your risk of getting HSV 1 genitally from oral sex is low but not zero.
If you were going to develop symptoms, you would do so in 2-10 days from the experience, but not everyone develops symptoms when they get infected.

Terri
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15 months ago
Thank you. I have a few follow up questions:

1. Low but not zero - would you be able to further describe how low? Any percentage for my reference?

2. If I were to get a Western blot to check for HSV-1, how long do you suggest I wait? 

3. How likely/common is it to get infected but do not develop symptoms? (Perhaps statistically?)

I'm very worried and I appreciate your time getting back to me, thank you.
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Terri Warren, RN, Nurse Practitioner
14 months ago
1. Low but not zero - would you be able to further describe how low? Any percentage for my reference?
Sorry, I don't have a percentage but probably less than 5%

2. If I were to get a Western blot to check for HSV-1, how long do you suggest I wait? 
12 weeks 

3. How likely/common is it to get infected but do not develop symptoms? (Perhaps statistically?)
70% of people with HSV 1 don't know they are infected and 86% with HSV 2

I'm very worried and I appreciate your time getting back to me, thank you.

You're welcome

Terri
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