[Question #422] Can you get genital HSV 1 if you have already have HSV 1 orally?

34 months ago
If you have HSV 1 orally (existing infection, not a new infection, so antibodies are present) is it possible to get genital HSV 1 as well if you have sex (oral, vaginal, and/or anal) with a partner diagnosed with genital HSV 1? Or a partner diagnosed with oral HSV 1, but performing oral sex?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
Good question.  In 33 years, I have heard of this three times now.  It is so unusual that if this was me, I would not change my sexual practices to accommodate this very small risk.

Terri
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33 months ago
Just a quick follow up. I am taking 500 mg of valacyclovir daily for asymptomatic HSV1 (my sexual partner tested negative for both HSV1 and 2). If I decide to try and get pregnant, I've read that I should discontinue use of valacyclovir, but how long before trying to conceive should I stop using it (not sure how long it remains in the system)? Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
Some providers prescribe acyclovir during the whole pregnancy, others stop it once they know they are pregnant, this is something you should discuss with your OB provider to learn how they manage the medicine during pregnancy - it truly does vary all over the place.  It is not a dangerous drug during pregnancy, if that's what you are asking, and you would likely resume daily therapy towards the end of pregnancy to avoid a genital outbreak at the time of delivery, if you happen to have it genitally.

Terri
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31 months ago
I've been taking 500 mg of valacyclovir daily for asymptomatic HSV1 as I am in a sexual relationship with a partner who tested negative for both HSV1 and HSV2. I don't know if I have HSV orally or genitally, so we use condoms regularly, however I have not performed oral sex on him without a condom yet because of the fear of giving him genital HSV1. We've been discussing taking that risk lately, and I'm wondering if doubling up on my daily dose of valacyclovir for a couple of days before would help cut the odds that I might be shedding the virus at the time? Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
31 months ago
Actually, the research doesn't show a whole lot of difference between the effectiveness of once a day vs. twice a day, but the research has been done on HSV 2, but not HSV 1.  Remember that the screening test for HSV 1 misses one out of four infections compared to western blot so he could actually be infected and the test might not pick it up.  If he is quite concerned it would not be out of line to talk to your provider about increasing your dose to 500 mg twice a day - 1000 mg was the first approved dose; 500 mg is actually a secondary dose. 

Best of luck with this, Jane.

Terri
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30 months ago
Last question to close this thread out (and related to Question #712; I apologize for asking in a separate thread). Per your prior response re: reasons for possible false positives for HSV2 in the IGG test; "There appears to be another protein that some people have in their blood that looks like one of the proteins in the HSV antibody test that trips the test in some people." What is the name of that protein and does it appear on regular blood test results (like albumin or globulin)? I'm sorry for asking, just trying to find a way to calm my partner's nerves.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
30 months ago
We know little about the protein, Jane, only that the weight is similar to one of the proteins on the HSV antibody.  More and more we are seeing indeterminates on the western blot and this protein appears to be responsible for most.  I would say at least 15% of HSV WB are indeterminate now, which is frustrating for people for sure.  It is not something that would show up in any other blood test that I know about, no.

Terri
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