[Question #6721] HSV and oral

11 months ago

Hello,

I am writing because I was diagnosed with HSV-1 by a blood test about 10 years ago. The diagnosis came as a complete shock to me because I have never been a very sexually active person and as far as I know have never experienced any type of herpetic outbreak.

I have never had a cold sore anywhere around my mouth at all but I do occasionally get what I believed to be canker sores in my mouth. They do not start off as a blister and then leak, they do not cluster or look anything like the pics I see online. They simply start as a painful ulcer type lesion that hurts for a few days and then goes away and look EXACTLY like all of the canker sore pics I see online. It’s always just one ulcer that pops in a random area inside my mouth. I would say this happens only a few times a year and many members of my family experience the same thing.

When I was diagnosed, I had been in a monogamous relationship for about 3 years at the time and he decided not to get tested for HSV because we assumed that I must have given it to him by that point. We continued our sexual relationship under that assumption and did not start to use condoms for oral sex. We also continued to make out even if I had a ‘canker sore’ in my mouth but I stopped performing oral on him when this happened, although I had done so before my diagnosis.

Fast forward to the present day and the two of us have decided to end our relationship. We both got tested. Not only did my blood test come back positive for HSV-1 (HSV 1 IGG, TYPE SPECIFIC AB 56.00) but it also came back as positive for HSV-2 (HSV 2 IGG, TYPE SPECIFIC AB 3.29). We both figured his would come back at least positive for HSV-1 but he is negative for both.

I am so confused by these results. He has been the only person I have been intimate with in all of that time so, to me, none of this makes any sense.

I am also now afraid to start any type of new relationship or even be intimate with anybody else ever again. I asked my doctor if I could be put on daily antiviral meds but he won’t prescribe them to me because I don’t have outbreaks.

I have friends who get cold sores and they tell me that if you don’t have an active outbreak, oral sex is fine and they often engage in that activity without telling their sexual partner. If you go online, there is varied information all over the place. One website said you can even pass it on my hugging and handshakes.

How can I be positive for HSV-1 and have not given it to my partner in 13 years? How have I now become positive for HSV-2 while my former partner is negative and he has been the only person I’ve slept with? Will I now have to always perform oral sex with condoms even though I don’t believe I get outbreaks?

Any help you guys could give me would be so appreciated. Thanks in advance.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
You absolutely need a herpes western blot for clarification of your herpes status.  The CDC recommends confirmatory testing for everyone who tests between 1.1 and 3.5.  There are false positives in this range and given that your partner is negative for HSV 2, this is even more important for you.  You work with your own provider to obtain this OR I can order it for you at the home pages of westoverheights.com. 
It is also possible that your partner's test missed and HSV 1 infection - it misses 30% of HSV 1 infections, compared to the gold standard western blot. 
It is clear that you have HSV 1 but the canker sores are not herpes.  You may have been infected as a child by a family member kissing you with a cold sore and have simply not had a recurrence that you recognize.  And we cannot know if your infection is oral or genital.  Do you ever get outbreaks in your nose?  That's another location we see virus activity sometimes in people with oral infection.

Terri
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11 months ago

Hello,


Thank you for the information. I would very much like to get the western blot done through your website. I appreciate it. 

It just doesn’t make sense that I am now HSV 2 positive if he is not.


Also, no I do not get outbreaks on or in my nose or genitals. I have never seen anything that looks like clustered bumps that leak and scab over anywhere on my body.


Another question, if my recent ex ends up being truly negative for HSV 1 even though  I have performed unprotected oral sex on him for 10 years and I do not get outbreaks, how likely am I to pass this on to a new partner? What if I can find a new doc that will prescribe me antivirals and I opt to go on a daily dosage as well? 


I have a new casual nsa friend. I initially selected him bc he was experimenting and wasn’t interested in going that far w another guy and I was relieved bc I wouldn’t have to have the conversation with him. However, he has recently been wanting me to perform oral on him and I have refrained from doing so. I know, without a doubt, that if I inform him of this, he will not want to hangout with me anymore. If I can’t give him everything he wants, he could very easily go and find another guy that will and I don’t want to lose him as a friend. 


If I got the occasional outbreak, I would understand being upfront but if I don’t get outbreaks, didn’t give it to my ex of 10 years AND went on daily antiviral medication, shouldn’t my new friend be ok?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
We can certainly do the blot for you at westoverheights.com, yes.  Great idea.
We don't have statistics on the transmission of HSV 1 from mouth to genitals.  Given that you never infected a long term partner with HSV 1 AND you don't have outbreaks AND you are on daily antiviral medicine AND that half the US population has HSV 1, I think the likelihood of you transmitting to this new partner is incredibly small. 

Terri
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