[Question #1859] Herpes Transmission Question

78 months ago
Hi, I am a female who was diagnosed with herpes about 19 years ago.  I had only had 3 sexual partners.  When I was diagnosed I was with my now spouse.  I had been with him for 6 months.  That is when my outbreak occurred.  He told me I was his first which led me to believe I had gotten it from the previous partner.  But now I'm wondering because it was past the 2-10 days or so an outbreak would occur.  My spouse who says I was his first gets cold sores on his lip.  Is it more of a possibility I could have hsv 1 from oral than hsv 2?  I have a call into my dr to get a test as I really want to know.  Also my husband and I have had unprotected sex for years and he has not gotten genital.  I had an outbreak about 2 months ago but prior to that has been years.  3-5 at least.  When first diagnosed I got 3 or 4 painful outbreaks frequently but then subsided.  If I have a new partner, take valtrex and use condom it's my understanding transmission pretty low?  
Terri Warren, RN, Nurse Practitioner
78 months ago
So when you were diagnosed, typing of the lesion was not done?  Yes, it would be good to know what you have and from what you have described in terms of outbreak frequency, it sounds more like HSV 1 than HSV 2 to me.  And if you did acquire HSV 1 from your partner who gets cold sores,then it is extremely unlikely that he would than acquire HSV 1 genitally.  Of course it could be HSV 2 from a former partner but the time to first outbreak fits more with your spouse, right?  The thing about the IgG test is that is misses about 30% of HSV 1 infections so if you test, and it is negative for both, and you had a positive swab test in the past, then I would strongly suspect HSV 1.  However, if it is positive for HSV 2, you'll know your infection is HSV 2 or if the HSV 1 only is positive, then I think you can assume you have HSV 1 genitally.  The other way to get clearer is to swab a lesion.