[Question #2477] HSV 1 Genital Transmission

46 months ago
I am a 36 year old Woman from Trinidad in the Caribbean and I wanted to know what is the risk of transmission of hsv1 acquisition genital to genital transmission.  My timeline:-

2002 - A couple of weeks after first getting intimate with my first boyfriend I developed painful vaginal blisters, swollen lymph nodes and painful urination.. I had no clue about herpes etc at the time and the symptoms cleared in a couple weeks (I never had a single vaginal outbreak after that).
2005-2010 - I had three sexual partners  - never had any breakouts, symptoms etc from me or them to my knowledge.
2014 - I did a random IgG test after doing some research - results -  HSV1 Positive 3.17  and HSV2 Negative <0
2015 - Got 4-5 tiny paper cut blisters around anus and tender groin lymph nodes the very next morning after wearing a thong underwear so tight I had to peel it out of the skin between my buttocks (I applied antiseptic cream between my buttocks that night). The blisters went away after 3 days or so.

I have not been sexually active since 2010 February because I have been single since.

I have 2 questions:-

1. Is it possible to have the first HSV1 recurrence 12 years after the initial outbreak?
2. What is the possibility of HSV 1 genital to genital  transmission after more than 10 years?

I have worried a lot about this in the past to the point I had a sudden dramatic increase in blood sugar, blood pressure and heart rate for many months. I am thankful the results back in 2014 were negative for HSV 2 but I am still concerned about HSV 1.



Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Yes, it is most certainly possible to have a first recurrence of HSV 1 years after your first infection.  HSV 1 genitally rarely recurs and your description fits very nicely with the infrequent nature of this infection, genitally.  Genital to genital transmission of HSV 1 is quite uncommon indeed - we don't have exact statistics, probably because it happens so rarely.  It does happen, don't misunderstand, but in my career of 33 years specializing in herpes, I have not personally seen it happen.  I have diagnosed many people with genital HSV 1 and all reported receiving oral sex from a partner just prior to their first outbreak.  If you want to decrease your chance of transmission even further, you could consider taking daily antiviral therapy. 

Please let me know if you have other questions.

Terri
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46 months ago
Thank you.  I have 2 additional questions:-

1. Would antiretroviral therapy be necessary everyday (even though I'm not having any outbreaks) or intermittent if I am experiencing an outbreak?
2. Would the symptoms I experienced in 2015 be indicative of a typical herpes recurrence after irritation from my thong underwear?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
antiviral therapy is not necessary but would be one method of reducing transmission to a partner genitally.  Since this kind of transmission is a rare event, at least as far as we know, I would not describe it as necessary - only one method to reduce the risk of transmission more.
It is possible that the irritation of the underwear was enough to reactivate the virus by annoying the nerves in the genital area, yes.

Terri
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46 months ago
Thank you for the info. One more question can genital HSV 1 be transmitted from the vagina to another person's mouth who is performing oral sex?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Yes, that is theoretically possible, but because HSV 1 shed infrequently, that is quite unlikely to occur.

Terri
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