[Question #1559] ? for Dr. Handsfield
80 months ago
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Good Evening Dr. Handsfield, thank you for
this valuable service. I was recently diagnosed with G-HSV1 and would
like to start a new relationship with someone who is HSV1 negative. I
read this article and have some
questions: https://thehairpin.com/how-i-found-out-i-didnt-have-the-herpes-i-d-been-living-with-for-four-years-5a30c2ac9efc#.pyuy532qm
-"As long as I use protection, Dr.
Handsfield told me, 'I think you can make a perfectly valid ethical argument
that there’s no need for disclosure because the risk of transmission, even if
you’re infected, is very, very low.'"- is that just if you're sleeping
with multiple partners, what if you're in a committed relationship and don't
want to use condoms? As i understand condoms don't fully protect, my
lesion was on the perineum.
-in the article, if her antibodies are
no longer detectable, does that mean she is at risk to become infected orally
even though she had been infected genitally in the past?
-regarding my condition i contracted it from
a boyfriend with oral HSV1 in 2014 but i didn't have my first symptoms until
2016. Would that be considered my primary outbreak years later? my
concern with that is, could have autoinnoculated myself (mouth, eyes), or
were the antibodies already present even before the first noticeable outbreak?
Thank you, i look forward to hearing your
response.
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Terri Warren, RN, Nurse Practitioner
80 months ago
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I'm a little confused about one thing you wrote - if you contracted this in 2014, but didn't have symptoms until recently, how do you know you contracted this is 2014? If that's correct, then yes, you had antibodies present before this first outbreak that you noticed, correct. You would normally make antibody within 3 weeks-3 months. This outbreak that you having now would not be considered a primary but rather a recurrence. Autoinoculation after the infection has been established, about 3 months, is extremely rare and I wouldn't spend time worrying about that.
If you are in a committed relationship, I personally think it is best to disclose and if your partner it truly negative and feels strongly about staying negative for HSV 1, then condoms and daily antiviral therapy would be the best ways to reduce the risk of infecting him. You mention that he is HSV 1 negative - does that mean that he has actually tested negative by IgG or just doesn't believe that he is infected? And remember that the antibody test for HSV 1, according to a paper we are about to release, misses about 30% of HSV 1 infections. That's far higher than the percentages listed in the writings that you list above.
And that leads me to the next part of your post which describes someone whose antibody is no longer detectable. There are a few explanations for that: 1) the test is missing her HSV 1 infection due to the poor quality of the test or or 2) she experienced what we call seroreversion or 3) she didn't have herpes. It happens, albeit rarely, with the IgG test but not with western blot. If I had to bet, I'm guessing it was the first. HSV 1 often never recurs and this could have been the case with her. It's not possible to know what happened here as she didn't pursue the western blot apparently.
If your partner has not been tested, it might be useful for that to happen, just to know with about 70% certainty, what he does and doesn't really have.
Terri
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80 months ago
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80 months ago
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Terri Warren, RN, Nurse Practitioner
80 months ago
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Seroconversion is going from a negative test result to a positive one, sorry for using "the lingo" with an explanation.
I'll ask Dr. Handsfield to look at your post and let me know if he wants to add something. Are you asking about his statement quoted on disclosure?
Terri
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H. Hunter Handsfield, MD
80 months ago
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80 months ago
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Thank you Dr. Handsfield and Terri for both of your
responses! It is invaluable to have such
experts in the field care about us who are trying to cope and understand our diagnosis and disease.
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Terri Warren, RN, Nurse Practitioner
80 months ago
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Terri
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H. Hunter Handsfield, MD
80 months ago
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