[Question #2338] More HPV Concerns

46 months ago
Do you disclose that you have/had the HPV strains that cause cancer/ require surgery?

If you have sex with someone who has had surgery because of HPV, even if it was years ago, can I acquire the virus?

I get cuts on my lips and my dad often has cold sores, and when i have cuts and burns on my lips and he has active cold sores at the same time (we smoke tobacco too, and I burn myself trying to sterilize the pipe sometimes, and othertimes i don't relist it at all) is there any chance of spreading HSV-1 through such contact with pipes, food, etc.? This has happened serveral times throughout my life. Enough to warrant an HSV-1 test?

Also, is it possible to get HSV-1 from sharing toothpaste?

I'ved shared toothbrushes in the past with people who have active cold sores. My gums are also sore usually when I brush because I am a smoker and this leads to more abrasioin and bleeding.

I've also shared a toothbrush with my friend who has cold sores off and on but I'm not sure if he had one when we shared it.

I've also shared a toothbrush with my mom and her boyfriend before, but my dad gets cold sores so she probably has it too; and also the boyfriend is quite old so I'm sure he probably has it as well. Am I being paranoid? I don't want to get tested but I keep finding reasons why I might be infected with HSV-1
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome back to the forum. I reviewed your previous discussion with Dr. Hook and agree with all he said. But I fear you just aren't getting it. On one hand, your replies indicate you understand Dr. Hook's comments; and the questions you continued to ask then,a nd to some extent now, indicate that you either didn't fully understand or didn't quite believe his opinions and advice.

As Dr. Hook said, disclosure of past STDs doesn't have a single yes/no answer. But in general, there is little need to disclose past HPV infections of any type, including infection with high risk (potentially cancer causing) types. Knowing of a particular exposure doesn't allow the recipient of the news to do anything useful; and it doesn't reduce his or her chance of getting cancer or other serious health outcome. The high risk HPV types are the most common; knowing about a particular exposure doesn't elevate that person's risk any higher than it otherwise is.

Most HPV infections are cleared by the immune system, and surgery for HPV problems also helps clear it and reduces transmission risk. Someone who had HPV 11 years previously, and had surgery, is unlikely to still be infected now. And you've been vaccinated, so you're probably no longer susceptible that that HPV type anyway.

Oral HSV1 is rarely if ever transmitted in the ways you describe. Almost all infections are acquired by direct personal contact with an infected person, i.e. kissing or oral sex. Sharing toothpaste is probably very low risk; not enough virus would be carried to the exposed person, and anyway most toothpastes probably inactivate the virus. Sharing toothbrushes (not paste) may be higher risk. Sore gums do not suggest herpes. (But I think you have a misunderstanding about your apparent gingivitis, which is not likely due to smoking. This is something to discuss with your dentist. It is not normal to continually have sore gums or to abrasion and bleeding because of brusing.) In any case, I would advise you to stop sharing toothbrushes -- not only because of herpes, but because it is inherently unhealthy. If nothing else, it's an excellent way to transmit colds, influenza, and other viruses.

Given all these HSV1 exposures, and having been raised in a household with a parent with oral herpes, there's a very good chance you have it. You can have a blood test to know for sure. If positive, it will not explain your gum disease. Half the population has HSV1, and the vast majority have no health problem from it. If you decide to be tested and would like to post the result, I would be happy to comment further about it.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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46 months ago
I have shared toothbrushes, but I'm not sure if they had 'active' cold sores as I said, but it was my mom and her boyfriend, so chances are they have the virus; anyway, I don't think I shared it too many times. Let's assume I had just to be safe.

So let me get this straight: I should be tested due to all these exposures? Dr. Hook seemed to say No and don't worry about it, but on the other hand you are saying go ahead.

Also, you say that the ways I describe rarely if ever transmit the virus and yet in your last paragraph you say "given all these exposures" as reason given to support why I probably have the virus. Just a little confused

What exactly are the guidelines for when to be tested for HSV-1?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
No, you should not be tested on account of these particular exposures. I agree with Dr. Hook. I'm not recommending it, just saying it's an option if you would like to know for sure if you have HSV1. Half of all adults in the US test positive, and your risk may be somewhat higher than that, given being raised by a person who might have oral herpes.

I'm not sure what you're confused about. Even if the risk of any single exposure is very low, obviously the chance of infection rises if there are many such events.

There are no formal guidelines on HSV1 testing. Some reasons are when someone has genital herpes but the virus type isn't known, when a blood test can tell whether it's caused by HSV1 or HSV2, which is important in treatment and protecting partners; in people with symptoms that suggest oral herpes to help confirm the diagnosis; some patients before getting certain very potent kinds of immune suppressing therapy which is known to risk reactivation of HSV1 with serious complications; and others.
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46 months ago
Okay, well I've shared a lot of toothbrushes in my life with family members and friends that get active cold sores; I'm not SURE if they had one when I shared with them, but let's assume they did. Is this still not sufficient to get tested? I don't particularly want to be tested for it but I also am just trying to do the right thing. I don't really want to worry about this at all and would prefer to continue living my life as normal, although now I will certainly not share any toothbrushes.

I've also shared razors too sometimes with my family (parents (aunts?)) and friends who get cold sores. Is this anything to worry about either? I don't know why I'm so paranoid about this but I'd just prefer to forget the whole thing if it's okay to do.

And lastly, does kissing someone who gets cold sores warrant testing either? I'm not sure if I've ever kissed someone with an active cold sore but probably(?) who knows, but certainly someone had the virus, although I'm not 100% sure it's very very likely. I just want to be free from anxiety about all this. Thank you for your advice and sorry for all the repetitive questioning if it comes out that way. I appreciate your work here.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
I'm not in charge of whether or not you are tested. You are at elevated risk of HSV1 from living for years in the household of infected parent(s), presumably with typical parental care and contact (e.g. kissing and other close contact). The toothbrush sharing might increase the risk a bit further than otherwise, but is not in itself reason to be tested. Same for razor sharing and kissing:  low enough risk for any particular exposure that testing is optional. Even sex partners of persons known to have HSV (either HSV1 or 2), testing is optional. Exposure during outbreaks isn't necessary for transmission to occur:  the virus is often present in the mouth in absence of symptoms.

There is no requirement for anyone to know for sure whether or not they have HSV1, and you are free to "forget the whole thing". However, it is clear you are obsessed with the possibility you may be infected with HSV1, and my guess is you'll continue to fret about it unless and until you are tested. (If or when you are tested, make sure you do NOT have an IgM antibody test, only the IgG test. The HSV IgM test is very unreliable.)

That concludes the two follow-up questions and comments included with each question, and so concludes this thread. Please note that repeated questions about the same exposure, symptoms, or disease concerns are not permitted. This being your second, any further ones will be deleted without reply and without refund of the posting fee. However, if you decide to be tested for HSV and the result is positive for either HSV1 or 2, feel free to post another question about it, which will be answered by Terri Warren.

Thanks for the kind words about our services. I hope the discussion has been helpful.

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