[Question #6974] Genital HSV-1

11 months ago



I have browsed through this site but have yet to find an answer to this question: is the reason genital to genital HSV-1 transmission is so low because recurrent outbreaks and shedding is typically infrequent? Or is there another reason? What happens if one experiences frequent genital HSV-1 outbreaks: are they more likely to transmit it to their partners than "typical" genital HSV-1 cases?


As background, I was diagnosed with genital HSV-1 via a swab test about 4 years ago - I just happened to be at my doctor's for another issue when she noticed a small lesion in my vagina. I understood that since it was HSV-1 I would likely not experience many outbreaks. In retrospect I recall having lesions in my genital region (at the top of the butt crack, an area I did not associate with genital herpes at the time) at least once more than 10 years ago, so I do believe it has been well-established. I simply never noticed.


I hadn't thought much more about it until recently, when I discovered what I thought were "hemorrhoid flare-ups" were actually herpes. Granted, I have not had these swab-tested, but they do look and feel identical to what I have been tested positive for before - small lesions that blister and usually break open. I believe what I thought for years were hemorrhoids were in fact small, barely-noticeable herpes outbreaks. Since I "discovered" this the past year, I have had 5-6 small outbreaks within that year that do not last very long, usually 4-6 days. 


Also, I recently tested negative for HSV-2. I believe I have more frequent recurrences of genital HSV-1 than typical which now makes me wonder how communicable this actually is in my case.


Thanks for your help!


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
The reason genital to genital transmission is low is yes, viral shedding is infrequent.
I think you might be making some assumptions here that may or may not be accurate.  I think it is very important for you to get these swab tested to determine if these are actually outbreaks.  These are lots of outbreaks for HSV 1 genital infection.  And before you decide that you are more infectious than most people with HSV 1 genital, I think you should know for sure if your assumptions are correct.  I've had many patients who believe they are having outbreaks that turn out to be something else.  You certainly could be correct, but I think it is totally worth finding out for sure.