[Question #5567] Genital HSV-1

74 months ago

Hi, I was recently diagnosed with genital HSV-1 via a DNA PCR test from a swab of a sore on my vulva. My provider said I likely got it from someone who had cold sores on/in their mouth and may not have known they had the virus or maybe forgot it was so long ago? Before I broke out with the sores I had flu-like symptoms and was tested for the flu and it was negative. 5 days later I had itching inside my vagina similar to a yeast infection. After 4 days of failed yeast infection treatment, 6 very small red bumps appeared on my vulva. The day after the sores appeared my gynecologist tested them and prescribed Valtrex. The sores healed within a week. I did not have any antibody blood testing done. Is it safe to assume that this was truly a new infection and first outbreak because I had the flu-like symptoms and never experienced sores before that I’m aware of? Or is it more likely I really had a cold virus (or the flu just not detected by the test) and had a recurrent outbreak because my immune system was weakened, but I had never noticed symptoms of an initial outbreak? Also, now that I know I’m positive for genital HSV-1, how likely am I to give it to my partners (male and female) through unprotected oral, vaginal or anal sex (the sores were only on my vulva). I’ve read that genital HSV-1 is usually very mild compared to HSV- 2 and is likely to not recur again?

Terri Warren, RN, Nurse Practitioner

74 months ago

It sounds to me (and this is an educated guess) that this is your first infection but without any antibody testing done, it isn't possible to know for certain. I think it is likely that the flu symptoms were due to a new herpes infection, not influenza. HSV 1 does recur less often than HSV 2, that is correct, and is also shed less during asymptomatic periods as well. Transmission to sexual partners is uncommon through any kind of contact though not impossible. When having sex with people who do not have HSV 1 infection, it would be wise to consider daily antiviral medicine to reduce the risk of transmission and provide some reassurance to uninfected sex partners. It is possible that you wont' recur again but the average number of outbreaks per year, after the first year of infection, is an outbreak about once every other year. It would be wise to have antivirals on hand to treat outbreaks as they come up rather than having to wait for a refill or an office visit.

Terri

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73 months ago

Thanks for your reply. One last question, though: If this is my first infection, how likely is it that I was infected 6 months ago? Is it more likely that first infections appear with these classic signs days to weeks after becoming infected?

Terri Warren, RN, Nurse Practitioner

73 months ago

If these symptoms truly represent a first infection, it happen within the past couple of weeks, not 6 months ago. but remember that a first infection is far different than a first recognized outbreak, right? If that's what is going on , then infection could have happened 6 months ago. Without antibody testing, we just cannot know for sure.

Terri

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