[Question #4166] HSV1 transmission

30 months ago
I was diagnosed with genital HSV1 by a viral culture in 2011. I took a suppressive dose of Valtrex for 1 year to protect my partner. He tested HSV1 positive and realized he had passed  it to me via a herpetic whitlow on his finger. Since we were both HSV1 positive he stopped using condoms. Neither of us had any outbreaks during the rest of our 4 year relationship. Since that relationship ended I have not had any outbreaks and have been abstinent for 4 years. Now I'm dating again . I understand most older adults like myself have HSV1.  What is the risk of transmission of genital HSV1 during intercourse and oral sex with a new partner whose HSV1 status is negative?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
30 months ago
I certainly wish we had those statistics to give to you but we do not. I can tell you, anecdotally, that I have not seen nor has Dr. Hansfield seen nor has Dr. Hook seen a case of HSV one transmitted thru intercourse. However, it has been documented to occur in the literature. So I think what you should take from that is that the risk is very low but could happen. And easy thing to do would be to ask a partner to be tested for HSV one prior to having sexual activity with that partner. But the problem is, the IgG test misses about 30% of HSV one infections. An easy thing to ask a prospective partner would be have they ever had a cold sore on their lip or in their nose? A person with a genital type I infection sheds virus in frequently and as you have seen has few if any recurrences of this infection.

Terri
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30 months ago
Thank you for the info about HSV 1 transmission  during intercourse. What's the answer to the  question about the  risk of HSV 1 transmission during  oral sex if my partner is HSV1 negative?  Considering  I haven't had a recurrent  outbreak  in 7 years, would  taking a suppressive  dose  of Valtrex lower the transmission risk significantly enough  to avoid the use of a condom with    a HSV1  negative partner?( with the understanding  both our STD panels are negative and we are in a monogamous relationship)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
29 months ago
I'm sorry but we do not have that information.  But it is likely pretty unlikely given that HSV 1 is infrequently shedding or recurring.  Valtrex should definitely reduce the shedding and recurrence rate but by how much, we do not know I'm afraid.

Terri
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29 months ago
Is there a risk of HSV 1 transmission to a HSV1 negative partner from me receiving cunnilingus? What is the risk from me performing fellatio on a HSV 1 negative partner?  I want to get  all the most accurate information I can.  I told a boyfriendI thought I was going  to become intimate with of my HSV 1 status and he ended the relationship very abruptly. I hope it's possible to have fulfilling monogamous sex life again. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
29 months ago
Again, I am sorry, but  we simply don't have that information.   I can tell you that the risk of you receiving cunnilingus and transmitting is very low. And there is zero risk of you giving oral sex to someone else if you have only genital infection.   If you are having sex with someone who already has HSV 1 (cold sores) there is almost zero risk of infecting them genitally

Terri
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