[Question #7023] Hsv1 genital

9 months ago
Just over 2 years ago around 5 days after oral sex with a partner who has regular cold sores I found what looked to be very similar looking, 2 blisters down below in just the pubic area only along with nerve feelings in my legs and skin that felt sensitive to touch at the top of my legs (but didn’t look any different to normal) My partner had a cold sore coming up but we didn’t realise the consequences. I was pretty sure what had happened so I went to the doctors the same day who took a quick look and confirmed my suspicions. She didn’t swab them but gave me aciclovir. I haven’t to my knowledge had an outbreak since. I’ve also never really came to terms with it. It is something that I now have on my mind everyday as I’m not with the same partner anymore and am worried what this may mean for future relationships. I decided to do a type specific blood test a week ago which came back negative for both after reading up I found this could be a false negative for hsv1, why is that? Do you also have up to date information on transmission please? Also shedding without symptoms? 
I haven’t had another outbreak since, is it common to never have one again? Is this the usual trend? Do people tell their partners about this and do they find that it goes well normally? I’m really struggling to accept this
9 months ago
Hi I was wondering when you’ll be able to help me with this? I’m not sure how it works on this site? Thank you 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
There are a few issues here.  The lesion should have been swab tested when you were seen and if that had been done, you may not have been wondering all this time if it was herpes. The IgG test misses 30% of HSV 1 infections compared to the gold standard herpes western blot antibody test, so a negatiave on the IgG test, combined with your symptoms, maybe not be reliable.  If you were my patient, I would order you the herpes western blot to confirm your status.  You can work with your own provider to obtain this test.  You can contact the University of Washington, the only place doing this test in the US for the public, 206-685-6066, to get the kit you need to do the test.  Then you need to work with your own provider or with me at westoverheights.com to get this test ordered.  you've been wondering for two years - I would suggest that you get this superior test and get it cleared up, one way or the other.  It is important to note that if you do have HSV 1 genital infection, at this point, you would only be giving off virus on about 4 days out of the year.  So you may decide that you don't need to know this, but I doubt it.  Please let me know what other questions you may have.

Terri
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9 months ago
Thanks for coming back to me. I’m not living in the US so I think doing the test would be difficult. My doctor was sure that’s what it was and with the fact that my partner had very regular cold sores I believe it is true that I do have hsv1. It seemed pretty obvious to me too.
If there has been no outbreak since the initial one is it unlikely that it will come back? 
The 4 days a year does that mean I can certainly infect someone at that time? This is only 1.1% of the year? Will just using condoms Reduce the risk even further? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
If you've not had a recurrence within the first year, there is an 88% chance you will not have another.  So that's great news.
No, the four days a year is how often you will shed virus from the genital tract.  Shedding the virus does not necessarily mean you will infect someone.  This is particularly true because about half the population already has HSV 1 infection, so you are almost certainly not going to infect them at a new location (genital).  Condoms reduce transmission from males to females by 96% so certainly that would be helpful.  Daily antiviral medicine reduces transmission of HSV 2 by about 50% so we think it would also reduce the risk of transmission of HSV 1 to a sex partner

Terri
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9 months ago
Ok thank you that’s good news. Seems that it is very rare to pass the virus on then? I have heard that none of the experts had known this to happen before? I am a female and have heard that it is also more difficult to pass the virus from female to male than the other way round is that correct info? Does viral shedding and possible outbreaks decrease in severity and frequency over time? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
It is rare to pass HSV 1 genital infection through intercourse, correct.  And you don't know that you have this really, correct?.  Shedding does reduce, for most people, the longer they are infected, correct.  And men transmit the virus to women more often than the reverse, correct.

Terri
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