[Question #6663] HSV 1

14 months ago
I have been married for 20 years.  Recently, my husband developed sores on his gums that were confirmed to be the result of HSV 1.  I was unaware of this diagnosis, but this was then transmitted to me genitally.  I had a blood test done which was negative for both HSV 1 and HSV 2, though the blood test was done less than 2 weeks after exposure; I will be going back to get tested in upcoming months as I understand it takes time for antibodies to become detectable in the bloodstream.  My question is:  what are the odds that my husband (who I have never known to have a cold sore, etc) has been infected with HSV 1 for the duration of our marriage and not ever transmitted it to me despite neither of us taking any precautions to prevent anything like this?   If that would be unlikely, would there be any kind of rational explanation as to how he could have acquired this virus in recent years without kissing/sharing bodily fluids with someone else?  Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
When you say the sores in his gums were confirmed to be HSV 1, was this confirmed by a swab test of the sores?
It is certainly possible that he could have had HSV 1 for years and just infected you genitally through oral sex, yes.  it is also possible that your antibody test missed a long standing infection in you - the test misses 30% of HSV 1 infections.  However, if you test positive down the road, say in 6 weeks, then that's not what happened here. 
Do you have concerns that he has had another partner?

Terri
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14 months ago
Thanks so much for responding.  His HSV 1 diagnosis was confirmed via swab test.  I found this out after I had gone to see the doctor for what I assumed was just a strange yeast infection.  My doctor relayed my diagnosis just by sight though (no swab test).  My bloodwork came back as being negative for all STDs (I requested a full panel simply because of my shock of the diagnosis I had just received), though I will be going back in a few months to re-do the bloodwork since antibodies for HSV take some time to build up.                                                                                                                                                                                                      I understand that HSV can lie dormant for years, but that it can also be spread during periods "shedding"; I just have never had any indication of any kind of infection and if my husband has had HSV 1 for the past 20 years and we've never taken any kind of precaution to prevent transmission, I was curious as to what the odds were that I hadn't contracted this before now.  I am of course hoping that my husband has not recently had another partner who could have infected him with this, though I'm also not naive and feel that his HSV 1 could have been acquired this way.   Honestly, I'm just really trying to understand how this all happened.  Thanks so much again...
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
So a positive swab test from a gum lesion is a tricky thing.  People with oral infection shed virus periodically and it can be recovered from the mouth through swab testing, EVEN if the swab test was done from a canker sore, which is not caused by HSV 1.  But HSV 1 can be present.  So difficult to know.  Or the lesion could have been caused by herpes. 
I don't think that you should be certain at this point that the visual diagnosis is correct.  The CDC says that a swab test should have been done from whatever your doctor saw.  That wasn't done.  Now you will need to wait for a further antibody test.  If the test continues to be negative, either the test is missing an HSV 1 infection, which it does 30% of the time OR it wasn't herpes.  I hope you will pursue this further.
I think it is entirely possible that he's had this for a long time and just recently infected you.  We don't have any statistics about that, however.

Terri
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