[Question #4070] options for managing herpes

33 months ago

I'm a heterosexual man. I recently tested negative by blood test for both herpes strains. I've never experienced herpes symptoms. I've never had sexual contact or kissed anybody, but likely will in the future.


These are the options I'm weighing for managing herpes with some questions:


Option #1 – I'm thinking about deliberately causing a genital HSV1 infection to preempt an oral infection. My reasoning is that most people get HSV1 at some point. I don't like the idea of HSV1 symptoms on the face, but the idea of having it on the genitals does not sound as bad, as symptoms are not as visible.


From what I understand, somebody infected with HSV is unlikely to get re-infected with the same type in another part of the body.


Is it possible to obtain an HSV1 infection from a medical professional, or would this have to be done in a non-clinical setting? What is the likelihood that HSV1 will indeed set up a genital infection and not become an oral infection?


Besides the location of the symptoms themselves, in what ways does a genital HSV1 infection differ from an oral HSV1 infection? Are there differences in the average frequency of outbreaks, etc? I want to make sure genital HSV1 isn't worse, just a different location.


Option #2 – The other alternative is to choose a partner based on the results of a blood test for the disease. How likely would this plan be effective at preventing me from getting infected? How could it fail?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
It is not possible to obtain HSV 1 from a medical professional no, and I think you should reconsider this plan as even though HSV 1 genitally recur infrequently and not show, it has a stigma that oral HSV 1 does not.  It does recur far less often than HSV 1 oral infection. 
The other plan, having sex with people based on their test results, is OK except that the IgG test misses 30% of HSV 1 infections (I am making the assumption that you have been tested for HSV 1 and are negative)

Terri
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33 months ago
Thank you! Follow-up questions for each option are as follows:

Option #1 – deliberately causing a genital HSV1 infection to preempt an oral infection

Do you have any information which quantifies how much less often HSV 1 recurs in a genital infection than in an oral infection?

Let's say I end up choosing this option of causing a genital infection to preempt an oral infection. What's the best way to go about obtaining a genital infection? Would it be to simply ask for oral sex from partners but refuse to kiss them? Or are there any books on “do it yourself virology” or “home bio-hacking” where I could learn to isolate the virus and give myself an injection?

Here’s a related question: Are there different strains of HSV 1 out there which recur more frequently than other strains of HSV 1? Let’s say I found somebody with bad case of oral herpes. Would there be a risk of me picking up a particularly “bad strain?”

Option #2 – Avoid herpes by choosing a partner based on the results of blood testing

Is there any way to reduce the possibility that IgG testing is providing a false negative for HSV 1? For example, what about having a prospective partner take multiple IgG tests spaced out over time? If so, please provide links to quantitative information.

What is the percent for false negatives in HSV 2 blood testing?

Thanks again.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
HSV 1 orally sheds on about 25% of days, HSV 1 genitally, about 5% of days.
This is a very odd conversation but to acquire HSV 1 genitally, most people receive oral sex from someone with an active cold sore.  I think you might have a hard time making this happen.  I am unaware of do-it-yourself herpes acquisition instructions.  There are different strains of the virus yes, but I think most HSV 1 genitally is pretty mild though I am certain there are exceptions.

The best way to sort out a negative partner for HSV 1 is the western blot - it is far more sensitive than the IGG test for HSV 1 and 2.
The IgG test misses 8% of HSV 2, compared to the gold standard western blot

Terri
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32 months ago

Hello again. Thank you for the great information!


You had indicated that there are indeed different strains of the HSV 1 virus, and that most HSV 1 strains are pretty mild when infecting the genitals, although there are exceptions.


Assuming I end up choosing the option of causing an HSV 1 genital infection to preempt an HSV 1 oral infection, and that I’m successful in doing so despite the logistical difficulties you mention, I'd want to make sure that the strain of HSV 1 with which I become infected is the most mild strain possible.


Has medical science classified and named each of the HSV 1 strains? If so, what is each of their names? How many HSV 1 strains are there, and what is the severity profile of each (with respect to the extent which it manifests symptoms)?


Are there tests available which can differentiate between the various HSV 1 strains? For example, let’s say I find a candidate who is willing to offer me oral sex. Could I send her for some kind of a test to make sure she’s got the most mild strain of HSV 1 out there?


I assume it’s not possible to acquire more than one HSV 1 strain. (Please correct me if I’m wrong.)


As for false negatives, you indicated IgG blood test misses 8% of HSV 2 and 30% of HSV 1. However, I’m still not clear exactly what percent of each type the Western Blot misses.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
No, the strains do not have names that I am aware of and I don't know how many there are.
I know of no place that would identify strains and their virility, no
The false negatives are for IgG - the blot picks up 99.9% of HSV 2 and about 95-96% of HSV 1.
This discussion is closed. 

Terri
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