[Question #127] Dr Handsfield, does HSV-2 protect against HSV-1?

38 months ago
I have HSV-2 genital and my new girlfriend has oral HSV-1. 
She had an outbreak and we kissed and she performed oral sex while her sores were healing, but not completely gone.
It was about 5 days after her blisters appeared.
What are my chances of catching HSV-1 from her on top of my HSV-2 infection?
Does HSV-2 provide cross protection against HSV-1?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Good morning Stan.  I answer the herpes questions on this board but if you are needing Dr Handsfield specifically to give you another answer, you certainly post and pay for that if you wish.
A study by Dr. Zane Brown, looking at pregnant women, found that if a person is HSV 2 positive, there is about a 55,000 to 1 chance that they will acquire HSV 1 subsequent to having HSV 2.  So in essence, HSV 2 offers virtually full protection against the acquisition of HSV 1  Great news for you in this situation.  Also, you do know that you don't already have HSV 1 infection via antibody testing?  I might also ask - what sorts of things are you two doing to reduce the risk of her acquiring your HSV 2 infection?   Perhaps if you would like more information on transmission reduction strategies, I could help you with that?  Please let me know.

Terri
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38 months ago
Thank you for you answer, Terri!
I had IGG type specific test done with my first outbreak about a year ago. It came back HSV-1 at 0.5 and HSV-2 was over 2. Later confirmed by a swab test, plus I had other outbreaks, 5 total so far.
I'm on daily suppressive  of 1 gram Valtrex/day. My Dr prescribed 500 mg/day, but I was getting daily tingling and itching and so decided to try 1gm per day, it seems to be helping better. I'll try to cycle back to 500mg in a few months and see how that works.
Hopefully, Valtrex plus the fact that I disclosed my status to my gf will limit her risk of getting HSV-2. I don't know if she's been tested for it, so not sure of her status.
Back to my original question, my lips feel a little sore for the past few days, but I it could be just in my head, there are no lesions. Maybe from rough kissing and biting.
Based on your answer, I understand that my risk is virtually zero of getting HSV-1 either oral or genital now?
 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Yes, your risk of acquiring HSV 1 since you have HSV 2 is tiny tiny. 
It sounds like you are doing the best things you can to protect your partner (and condoms of course if you two decide to incorporate that option).  It might be good, at some point, for her to be tested for HSV 2 and if she is already positive, then this does not need to be a worry for you both. 
It is fine to be on 1 gram per day.  In fact, that was the first approved dose of Valtrex with 500 mg being a secondary recommendation.  However, most of try to start with 500 mg daily and if that doesn't work as well as we might like, then we easily bump up to 1 gram. 
By the way, Dr. Handsfield and I are at a conference together in Australia and we met this morning about something different and I mentioned your post and he completely agrees with my response - just wanted to let you know.
Best
Terri
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38 months ago
Thank you for all your help!
Just a last follow-up question, does her HSV-1 provide any immunity against getting HSV-2?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Good question, Stan. Her HSV 1 does not provide her any substantive protection, no, but what it does do is make it less likely if she gets infected that she will show symptoms of the infection or that her symptoms will be very mild.  that isn't true for everyone, of course, but it is true for most people.

Terri
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