[Question #5847] Genital HSV-1 Inquiry

18 months ago
I am a woman. I contracted Genital HSV 1 from genital to genital ( male to female) contact. This was confirmed by swab test. It has been nearly a year since getting diagnosed and I have not had another outbreak (my first one was not bad at all).  Do I need to disclose to future partners if I take valtrex daily and use condoms? I have been told by health professionals that it is not necessary to disclose as GHSV1 is not difficult to transmit. 


Secondly, have you ever seen a connection between the Keto Diet/Weight Loss and genital herpes outbreaks? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
So since your first infection was not bad at all (your statement) it is difficult to know if this was indeed your first infection OR your first recognized outbreak.  Both could be confirmed by swab test.  It is quite normal for HSV 1 genitally not to recur often at all.  In fact, the average number of outbreaks per year, after the first year, is 0.7, about once every other year. 
In terms of disclosure.   It is not likely important to disclose in terms of transmission but it could happen but it is important in term of trust and and from a legal perspective, though transmission is unlikely.  I can't give you a firm answer here.  Unlike HSV 2 where disclosure is essential, HSV 1 genital infection is shed infrequently.  I can't make that call for you and professional  are divided on this issue.  Let me know what YOU think.

Terri
---
18 months ago
How many cases have you seen of genital to genital transmission? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
I have seen zero - that is, I have not seen a case of HSV 1 genital infection where the person I diagnosed had not received oral sex in the two week prior to symptom development.

Terri
---
18 months ago
You will find my story interesting. I am now 27 and the only time I have ever gotten oral sex was from an ex boyfriend when I was 22. That summer I was having symptoms where I felt tired, sore throat, drainage in my ears, etc. I was diagnosed with EBV after bloodwork and got my tonsils out later that summer. 

Fast forward to 5 years later, and I have had a couple sexual partners and always used a condom. Throughout those five years I noticed red bumps on my vagina and assumed it was razor burn as I shave down there and was dealing with acne that was so severe, I was breaking out in pumples in random parts of my body and was put on a 6 month course of accutane. 

This past fall I was dating someone who I gave oral sex too, and I never had an outbreak on my lip. A few weeks later, we had intercourse. For about 30 seconds we did not use a condom. While we were intimate he spit on his finger, and then penetrated me with his finger. Earlier that day I shaved down there. 8 days later I had a genital hsv 1 outbreak which was confirmed by a swab test. Doctor told me it was for sure not hsv 2 but hsv 1.

Do you think I had genital hsv 1 and had no noteworthy symptoms until this past fall? Do you think I got genital hsv 1 from that partner when we did not use a condom (from his genitals?? Or is it possible he had it in his mouth and the spit on his finger entered a cut in my body and infected me. As I said earlier, my originally outbreak was very mild, and not bad at all.

Secondly, have you ever seen HPV misdiagnosed as genital hsv 1? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
HPV and herpes look nothing the same and the swab test confirmed your diagnosis. 
I think it is far more likely that you acquired HSV 1 from the boyfriend when you were 20 vs. the encounter your describe more recently for 30 seconds (not worried about the finger).  Probably far more people than we know have genital HSV 1 and don't know it for years because it recurs so infrequently. 

Terri
---