[Question #6752] Chance of herpes infection?

14 months ago
Dear doctor,

4 and a half years ago, an escort girl performed unprotected oral sex on me for 2 minutes approximately. Since then I have never had or felt any herpes symptom nor had any sex, and 5 months after the episode I did IgG blood test for HSV-1 and HSV-2 of which the result was negative. Despite that I am worried I caught herpes from that encounter, as I have read on the internet that some people can have the virus without any symptom ever showing and can still transmit it. Is this possible? At what chance/probability this can be my case?

Thank you very much for your time

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
I think if you've had no lesions, then it is unlikely that you acquired HSV 1 at this encounter.  But the IgG test misses 30% of HSV 1 infections compared to the gold standard western blot.  So if you want the best answer, do the blot.  However if the blot is positive, it cannot tell you where the infection is - oral or genital.  Please let me know further questions that you have, OK?  A negative result would provide you substantial reassurance if you are still worrying about this four years later.

Terri
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14 months ago
Thank you for your answer.

Regardless of doing a test, is it fair to say that it is unlikely that I got genital herpes from oral sex if still 4 years later I have not had any lesions? I don't know if herpes can easily be transmitted from the mouth to the genitals, and if that happens what percentage of people do not show any symptoms after a long period of time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
I think that is fair to say, yes, certainly unlikely.  Transmission from the mouth (cold sores) to the genital after a person has had an oral infection for about 4 months would be extremely uncommon.  The danger of that is with brand new infection when no immune response has yet been mounted.  Does that makes sense?

Terri
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13 months ago
Thank you. If I understood well, you are saying that only if the person (the escort girl) had caught HSV-1 recently, therefore with no previous immune response mounted, that she could transmit it by performing oral sex? Or did I understood you wrong and by 'person' in your previous answer you mean the receiver (me)? Because in my case I never had in my life an oral infection. But I also never had any symptoms 4 years later after that encounter, can it still be possible that I caught it genitally?
In other words (sorry just to make sure you get my question right), is it likely that If someone catches HSV-1 the first time genitally (and never caught it orally, so with no previous immune response mounted), can he still after 4 years of catching it the first time never have developped any lesions or symptoms nor had any outbreak? 
So to sum up, the scenario I am afraid happened is the following : Me, who never had herpes in my life, receives oral sex from an escort girl who does not have cold sores and who was shedding asymptotically the virus at that time, and catches genital HSV-1 because of that. And still 4 years later I never developped any symptoms or lesions, and my blood test is false negative. How likely, or unlikely is that?
If you could answer my questions and make things clear in my mind I would be very grateful.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
13 months ago
If a person recently acquires HSV 1 orally, it is possible though very unlikely, that they would then spread the virus to other parts of their body.  
It is possible that you were infected genitally, but have never had symptoms, even if you tested by the best antibody test, we could not tell you where the infection is located. 
If someone acquired HSV 1 genitally, they may never have symptoms, that is correct.  Even four years later.  But if someone is actually truly negative, and they acquire HSV 1 infection genitally, I think it is likely that you would have noticed some sort of symptom, and I'm sure you were checking very carefully after this incident. 
The likelihood that you were infected with a single oral sex encounter with someone showing no symptoms and you have no symptoms and you were infected and negative on an IgG test, it incredibly small!  Incredibly small!  If I were in your situation, I wouldn't give it one second more worry time.

Terri

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