[Question #1550] Followup Questions #1138

47 months ago
Hello Terri,

I am tested HSV1 positive and HSV2 negative after two weeks after my exposure in June. The OHSV1 outbreak on the edge of my upper lip in August remains red after it scabbed. The site also tingles most of the time, and I had two more subsequent outbreaks along the gum line.  

Does it mean I have higher chance of passing HSV1 to a HSV1 positive person (and how about a HSV1 negative person)? I am asking this senseless question because my partner tested HSV1 positive about 10 years ago is experiencing itchiness, numb and tingling (but no lesions) from upper arm to the back of hand in one arm for about 1 month after 2 months of dating. I recall he put his fingers into my mouth for several times and he trims his fingernails very short.

Would the immunity against HSV weaken over time or when the person is under influence of stress, alcohol and other immunosuppressants? I went for a second IgG test for HSV1 and HSV2 and am considering suppressive therapy to prevent from spreading HSV1 to other parts of my partner's body.

I would like to hear what do you think about my case. Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
Are you saying that the place you had a cold sore in August is still red?  is it like a scar?  That's pretty unusual.  And when you mention the gum line, are you talking about lesions inside of your mouth?  Though people do shed HSV 1 from the oral area, actual lesions in the mouth are usually not herpetic but rather are canker sores.  Without swabbing, we cannot be certain.  The average amount of shedding from the mouth area is 26% of days - that's pretty often.  If your partner already has HSV 1 it is EXTREMELY unlikely that he will now get herpes somewhere else on his body.  I don't see any reason to be on suppression to protect him at all.  People's immunity does decrease, not with time (it probably increases over time), but it may with stress, ETOH and immunosuppressants, like chemotherapy.

Terri
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47 months ago
Yes it is still red and irritating sometimes. It does not look like hyperpigmentation scar to me. I am also pretty sure about at least one of two outbreaks in my mouth because of the classical cluster blisters. I plan to go see a dermatologist after the break. I value your opinion a lot, so I wonder what you will say about it. 

My partner saw a doctor for his symptoms and the doctor thinks it is related to a shoulder injury he had years ago and recommend physical therapy first. I suspect there is no research on shedding of herpetic whitlow. But without the presence of lesions, I guess the shedding is unlikely because the skin is thicker?

Could my partner have IgM test in the past? I am not sure when does IgG become widely available. Do you recommend he re-test for IgG HSV1/2 without any history of cold sores and lesions on his body. I will report back on my test results when they are available.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
Herpetic whitlow does not shed unless there is an actual outbreak - the skin is too thick,  so no worries there.  Sounds more musculoskeletal to me, also.
If you aren't certain about his testing then, yes, it wouldn't hurt a bit to retest using IgG only to be certain of his status. 

Terri
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