[Question #6659] Herpes 1

12 months ago
My boyfriend has tested positive for Hsv1. I was tested negative back in October. He has tested positive in 2017,  with IGG) then negative with IGM in April 2019 and now positive with IGG. 
How likely is this that I will catch this from him genitally through oral sex? 
He has no cold sores ever so wasn’t even really aware of this and the doctor never mentioned it back in 2017. 
Is HSV1 the “better” of the two Hsv’s to have? 
How concerned should I be? 
Will this be a life altering condition? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
About half the US population has HSV 1 infection so it is extremely common.  The IgG test is the one that matters, the CDC says IgM testing should never be done to try to determine HSV status - it has an exceedingly high rate of false positives (when compared to the IgG results which are far more reliable).  So you mentioned that you tested negative.  The issue is that the IgG test for HSV 1 misses 30% of infections, compared to the gold standard western blot so this may or may not be accurate.  If he has never had a cold sore in his lifetimes on his lip or in his nose, we cannot know if his infection is oral or genital.  It could be either.  The good news is that if he does have oral HSV 1, people who have no symptoms give off less virus than those who have recurrent cold sores.  The other good news is that if he happens to have it genitally, genital HSV 1 recurs quite infrequently, is giving off far less between outbreaks than HSV 2  and is rarely transmitted via intercourse.  Life-altering?  not for most people, no.  I guess it depends upon your emotional response if you should acquire it, but medically and physically, it is not life-altering for the vast majority of people.  And if you acquired it and got frequent recurrences, you could take daily medication to reduce the frequency of recurrences.