[Question #253] Newly infected with HSV1

37 months ago

I’ve been very sexually active with the same girl (unprotected oral to me and unprotected genital) for 6 weeks.  3 to 4 days after we started having sex, I thought I had jock itch.  Dr.was treating me for that. We continued to have sex. It didn’t clear up. Dr. did swab test (Herpes Simplex PCR) - I tested positive for HSV1 & negative for HSV 2.  I had also developed a cold sore on my lip and had sores in my mouth. I was given Valtrex and Penicillin.  Dr. also did IgG test - negative for HSV 1&2 and IgM negative. It's pretty clear I contracted both oral and genital herpes. I will be taking 1,000 mg Valtrex daily for suppression therapy going forward. Does it make sense to do that for HSV1?

 

1.  Is it virtually 100% that my current partner transmitted this to me?  (I did have unprotected oral/protected genital twice a couple weeks before her)

 

2.  Read you can get HSV1 w/out visible cold sore on your partner.   I did notice she had a rash in her nose at one point.   Could that have been an outbreak?

 

3. If my current partner only has oral HSV 1, could she get genital from me if we have unprotected sex? Or protected sex?   Would I need to refrain from sex during an outbreak?  Do I have to use a condom all the time now with her?  I figured she gave me this virus so maybe this is not an issue.

 

4.  What about oral sex?  Can she continue to give this to me without a condom and it won't cause an outbreak of oral herpes for her? 

I don't know if she knows she has HSV1 or not but I don't want to bring it up if I don't have to.  I am the one who’s been infected.  Please help!

37 months ago
I just saw the name shown on my question which is the billing name only.  I am a guy! Hope this doesn't count as my follow-up.  I just didn't want you to be confused. Thanks a lot 


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
Hi,
Actually, I was a little confused!  LOL.  That does not count as a follow up, no worries.  It does sound to me like you contracted HSV 1 orally and genitally at the same time, I agree.  However, if you had another partner two weeks before this partner, it is conceivable that the HSV 1 came from this partner instead, though less likely, time wise.  Yes, you can certainly get HSV 1 from someone without them having a cold sore at the time of transmission.  If your current partner has HSV 1 infection, she is extremely unlikely ever to acquire HSV 1 from you in a new location.  You do not need to refrain from sex during an outbreak or from oral sex.  But here's the deal - she doesn't know you have HSV 1?  She doesn't know you've been going through this?  She is not at risk if she is infected but if not, then she is at risk!  I think you do need to bring it up.  And you don't need to point a finger at her but I do believe the discussion needs to take place.  She probably has HSV 1 genitally but since there was a possible contact 2 weeks prior, it is important to sort this out.  The problem here is that the screening test misses about 1 out of 4 infections, so even if she gets tested with the usual test, it could miss it.  The herpes western blot is far better at detecting HSV 1 but is available only in very specific ways.  If you are interested, I can tell you more.

Terri
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37 months ago
Hi again, a couple things from my earlier message I was still wondering about:

1. Could a nose rash indicate a breakout? Could that be swabbed for a PCR test?

2. Do you think I shouldn't be on Valtrex for suppression? I have a prescription for 12 months 1000 mg.  The doctor did write the prescription before the test results came back HSV 1 only.  I wanted to take it to prevent my own outbreaks (oral and genital) as well as provide additional protection for future partners. Would it do any harm, i.e. can I build up a resistance or will it lessen my ability to produce antibodies?

3. And something I forgot to ask before, I workout every day pretty hard. I came across something that said this isn't good for me now. Ie could trigger breakouts? Please tell me I'm wrong.

Thanks again for all your help

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
A nose rash inside the nostril or even somewhat outside could most certainly be a breakout and should be swabbed by PCR, yes
Being on suppression will not cause any harm at all and would be a good idea to help protect partners from infection, yes.  It is perfect but it is very useful.  And if you don't know the status of your current partner for HSV 1 and you aren't going to tell her, then I would most certainly recommend suppression but you know that I also recommend you talk to her about this.
Oh, what you read is definitely wrong.  Working out is in no way bad for your herpes!  In fact, it is great for your herpes no worries at all!

Terri
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