[Question #12068] Genital hsv1
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10 months ago
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Hi! I'm pretty positive (many many many IgG tests over the years) that I'm negative for HSV1. This has led me to an obsessive fear of getting HSV1 genially, by receiving oral sex. Sometimes my anxiety is allayed by simply examining the "worst case scenario", so here I am.
Few questions about genital HSV1!
+Let's say person A has oral Hsv1 and gives oral sex to their partner. Meanwhile person B has genital hsv1 and has penetrative sex with their partner. As far as I can tell, person A is more likely to give genital HSV1 to their partner than person B. Is that roughly accurate?
In other words, in terms of a person being a risk factor for giving their partner genital hsv1...the person with oral hsv1 is actually MORE of a risk than the person with genital hsv1?
+Is disclosure of genital HSV1 still considered a grey area as opposed to disclosure of genital hsv2?
+is it wrong to consider genital hsv1 as qualitatively different than genital hsv2? Or is that how the medical establishment views it, as a different category of STI?
+A lot of people don't know whether they have oral HSV1 or not especially if they never had a cold sore or don't remember/ didn't realize what it was. So in terms of personal responsibility and disclosure, if one feels compelled to disclose a confirmed case of genital hsv1, then the same should apply (if not more so!) to folks with oral hsv1 who may engage in oral sex?
Thank you! Of course any additional info you can share also helpful if it's in this ballpark :).
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10 months ago
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Also one addendum!
I know you have said IgG can often miss HSV1. But over the past 10 years I've probably had the IgG test done over 10 times. Probably more. Do some people for some reason have hsv1 but never have it show up on IgG, in which case I may indeed have been Hsv1 positive since I was young? Or is the "test misses 30% of hsv1" stat relevant on a test-by-test basis (meaning that if someone were hsv1 positive and tool the igg test over and over, it would be positive at least some of those times)?
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Terri Warren, RN, Nurse Practitioner
10 months ago
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You are correct - the person receiving oral sex from someone who has HSV 1 is more likely to acquire.
Disclosure of genital HSV 1 has no firm recommendation but I do recommend it.
HSV 1 is a completely different disease from HSV 2 when it is genital, correct.
It would certainly be helpful for people with cold sores to disclose that prior to giving oral sex to a partner, no question.
I think it is highly unlikely that after 10 tests, you would still be infected with HSV1.
Terri
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10 months ago
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Thanks so much! Last follow-ups:
+I think I've read on this forum before that genital-to-genital HSV1 transmission is rare to the point of almost unheard of. Does that still seem accurate?
+Is it still correct that symptoms of HSV1 or 2 would tend to appear within 2 to 12-ish days of exposure?
+I'm a little confused by difference between a "culture" of a potential lesion and a PCR test via swab. Let's say I some irritation pops up on my genitals and I'm concerned it could be HSV. How much time would I have to get into the doctor and have them do a reliable swab if it's PCR being used? I'd heard "24 to 48 hours" but that might be for culture...
+I think I've read on this forum before that genital-to-genital HSV1 transmission is rare to the point of almost unheard of. Does that still seem accurate?
+Is it still correct that symptoms of HSV1 or 2 would tend to appear within 2 to 12-ish days of exposure?
+I'm a little confused by difference between a "culture" of a potential lesion and a PCR test via swab. Let's say I some irritation pops up on my genitals and I'm concerned it could be HSV. How much time would I have to get into the doctor and have them do a reliable swab if it's PCR being used? I'd heard "24 to 48 hours" but that might be for culture...
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10 months ago
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Last follow up!
I have a partner who I see occasionally, about once a month. She has a history of cold sores. Sometimes none for a year, sometimes 4 a year if stress levels are high.
I know there's no easy answer here, but given that I tend to see her for a 2 or 3 day period once every month or so, I was wondering if she could take Valtrex prophylatically in advance of our meetings.
If so, how many days prior to our meetings should she start taking Valtrex? Any suggestion on dose? And would this be worthwhile and somewhat effective (I realize it doesn't bring chance of shedding down to 0%, etc)
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Terri Warren, RN, Nurse Practitioner
10 months ago
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+I think I've read on this forum before that genital-to-genital HSV1 transmission is rare to the point of almost unheard of. Does that still seem accurate?
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It isn't unheard of but it is rare. People are most infectious shortly after they acquire a new infection and far less infectious 2 years out, for example
+Is it still correct that symptoms of HSV1 or 2 would tend to appear within 2 to 12-ish days of exposure?
+Is it still correct that symptoms of HSV1 or 2 would tend to appear within 2 to 12-ish days of exposure?
Yes
+I'm a little confused by difference between a "culture" of a potential lesion and a PCR test via swab. Let's say I some irritation pops up on my genitals and I'm concerned it could be HSV. How much time would I have to get into the doctor and have them do a reliable swab if it's PCR being used? I'd heard "24 to 48 hours" but that might be for culture...
+I'm a little confused by difference between a "culture" of a potential lesion and a PCR test via swab. Let's say I some irritation pops up on my genitals and I'm concerned it could be HSV. How much time would I have to get into the doctor and have them do a reliable swab if it's PCR being used? I'd heard "24 to 48 hours" but that might be for culture...
Both methods look for the virus itself, but PCR is far more sensitive and can recover virus a bit later in an outbreak than a culture. If you don't have HSV 1, then yes, she could take antivirals for five days (optimally) prior to you seeing each other for transmission reduction.
Terri
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