[Question #7051] Genital Herpes

10 months ago
Can HSV1 be spread through strictly genital sex (so no oral-genital contact)?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
It can be, yes, but it rarely happens as HSV 1 is rarely shed from the genital tract, once it is living there.  Do you have other questions for me?

Terri
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10 months ago
Yes. Do you mean that genital HSV1 usually only resides in the basal ganglia (by the ear)? But even then, can genital HSV1 still shed from the genital tract during the initial outbreak, or is even that rare? And this would all imply that people who contract genital HSV1 are still at risk of later spreading it orally, aren't they?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
No, genital herpes virus would live in the sacral ganglia - oral herpes would reside in the trigeminal ganglia at the base of the head.  HSV 1 genital infection can definitely be shed from the genitals perhaps on around 13-15% of days with a new infection, and that would decrease after the first six months, and then greatly after two years.  Once a person has mounted an immune response to the virus (around 3-4 months), they are extremely unlikely to spread this to a new location on their body.

Terri
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9 months ago
Wow. So does that mean that: 

A. When HSV1 is genital (meaning it lies in the sacral ganglia vs the trigeminal ganglia), it not only sheds less than HSV2 (oral & genital) but it also sheds less than oral HSV1? Meaning, after two years, genital HSV1 almost ceases to shed (unlike oral HSV1, genital HSV2, oral HSV2)?

B. By "spread to a new location on their body", do you mean that if a HSV1 infection (oral or genital) is new, it can still be accidentally spread to different parts of that same person's body?


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
a.  Correct. 
b. Yes.  Before a good immune system has mounted, it is possible to transfer the virus to a new location on your body.  It doesn't happen often, but I definitely have seen it happen.
Terri
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