[Question #12610] GHSV1 to OHSV1

6 months ago

I contracted GHSV1 a year ago confirmed by a swab test on the sores. I have had maybe 3 minor genital outbreaks. Recently I had two outbreaks of sores inside my mouth/gums only, no genital sores. I thought transmitting it to another body area is rare. Can I assume I now have genital AND OHSV1? Given I have had multiple outbreaks in the first year of HSV (which I read is unusual) and it seems to be oral now, would this indicate a particularly infectious strain of the virus? Do you recommend disclosing OHSV1 if just kissing? How risky is it for a partner to contract it from giving me unprotected oral? If I give a partner oral, how risky is it to them unprotected? How possible would it be for me to transmit it if I had his testicles in my mouth? Or how possible if I gave him fellatio unprotected? This is all assuming I don't have an outbreak. What is the risk of transmitting it to him if we had protected vaginal sex?

Terri Warren, RN, Nurse Practitioner

6 months ago

Most sores inside the mouth are from canker sores, not herpes. If it happens again, I would definitely recommend that you get the sores swab tested to know if they are HSV or not, but it is less likely if your genital HSV 1 diagnosis happened a year ago and this is the first time you've had oral lesions.

Your questions assume an oral infection, which we do not know. And we also don't have transmission data from mouth to genitals from a person with oral HSV 1, but it is higher than the risk of transmission from genital HSV 1 because oral HSV 1 shed virus more often then genital HSV 1.

It is also possible that you acquired oral and genital HSV 1 at the same time but only had genital outbreaks at first, but again, that seems less likely because the sores are INSIDE your mouth as opposed to on the edge of your lip or in your nose.

Terri

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6 months ago

If it happens again (41F), I will get them tested. But this has happened twice now, the first time was maybe 7/8 months after I was first infected. I also had swollen lymph nodes under my jaw and my gums were swollen (both symptoms I had with genital outbreaks).

Until I can test, I need to know how careful I should be giving oral/should I disclose to partners?

1.How unlikely is it that I transferred the virus from my genitals to my own mouth?

2. Because I have had multiple genital outbreaks since the first bad outbreak, and from what I've read this is uncommon with GHSV1, would this indicate the strain I have is especially infectious? Or it means nothing?

3. In general, do you recommend disclosing OHSV1 to partners if you will only be kissing, given the ubiquitousness of it?

4. Questions a and b below about transmission were regarding the GHSV1 which has definitely been confirmed.

a. What is the risk of a partner contracting my GHSV1 in their mouth from giving me oral sex? We would really prefer not to use a dental dam.

b. What is the risk of a male partner contracting GHSV1 from me from protected vaginal sex?

5. There is no information about transmitting person A's OHSV1 to person B as GHSV1 during oral sex? I had read another answer here that seemed to indicate that skin on testicles/shaft is thick enough that it would be highly unlikely for these to contract HSV1 from oral sex.

Terri Warren, RN, Nurse Practitioner

6 months ago

1.How unlikely is it that I transferred the virus from my genitals to my own mouth?

unlikely but it is possible that you acquired both at the same time - kissed the person who gave you oral sex.

I don't know what to make of that.

3. In general, do you recommend disclosing OHSV1 to partners if you will only be kissing, given the ubiquitousness of it?

Probably not, but yes prior to giving oral sex. Some would disagree

4. Questions a and b below about transmission were regarding the GHSV1 which has definitely been confirmed.

a. What is the risk of a partner contracting my GHSV1 in their mouth from giving me oral sex? We would really prefer not to use a dental dam.

Low as genital HSV 1 normally doesn't shed often and more than 50% of adults in the US already have HSV 1

b. What is the risk of a male partner contracting GHSV1 from me from protected vaginal sex?

extremely low

I would disagree strongly with that. We are seeing far more genital HSV 1 than we used to, largely likely due to the increase in oral sex.

Terri

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6 months ago

Thank you - A few follow ups -

1. I would like to take Valocyclovir but 1. I believe it has made my hair thin. 2- it makes me feel extremely depressed. Maybe it would go away eventually, but it is hard to deal with this even for a short term. Do you have any recommendations for this? Would the other medications likely have the same side effects?
2. In another post you mentioned where (part of the body) men are most likely to shed (I think the anus was one part...). Do you have this information for women for GHSV1?
3. Does having HSV1 give me some protection from getting HSV2 as well? If so, how much approximately?
4. From reading your comments, it seems there is very little research on GHSV1. Why is this?
Thanks

Terri Warren, RN, Nurse Practitioner

6 months ago

1. You could try Famvir. It is a slightly different formulation.

2. The most likely location for male shedding is the shaft of the penis. For women, it is the labia, vagina and anus

3. HSV 1 doesn't give you protection from HSV 2 but it would make an acquisition of HSV 2 more likely to be mild or without symptoms.

4. There isn't a whole lot of research on HSV 1, you are correct. This is likely true because 1) HSV 2 is strongly linked to the acquisition of HIV and 2) it causes a lot more clinical issue - more recurrences and 3) about half the adult population has HSV 1 so it makes the acquisition of genital HSV 1 less likely and 4) HSV 1 genital infection recurs little and sheds little so less of an issue for most who have it.

Terri

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