Hello I'm trying to help a family member who recently acquired GHSV1 from oral sex.  She has been to several doctors and received conflicting information. I came across an article from an online magazine called "Hairpin"  in which Dr. Handsfield was quoted as saying that he had  never seen a case, to his knowledge, of genital to genital HSV1 transmission. It seems like there is no real data about this type of transmission so I will ask what your personal experience has been as a healthcare provider and if this quote is accurate?  She's had a tough time of it because her primary outbreak was quite severe (the worst her doctor had ever seen), had several recurrences(within the first 3 months) and trouble tolerating Valtrex.  So if it is true that you have never seen genital to genital HSV1 transmission,  this could offer a bit of good news that could be reassuring - especially since suppression therapy may not be a viable option for her.

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When the primary outbreak happened,  she took valtrex for 10 days and started to feel better (but like I said her outbreak was quite severe). However, within a few days it either came back or really didn’t go away and she was prescribed 30 days of valtrex - She started experiencing horrible insomnia and panic attacks. She thought it could be the medication or the trauma of the event.  But it did finally go away. However two months later she had sex and the very next day she had a recurrence. She took Valtrex  for five days and  again had horrible insomnia and panic attacks and stopped the medication. She felt like it took a really long time to heal - like 6-8 weeks. She’s afraid to take Valtrex again even though the doctor wanted her to go on suppressive therapy. Have you heard of others having this experience? I think she really wants to avoid taking Valtrex  but of course she doesn’t want to spread something  to potential partners so that's why I was asking about your experience with genital to genital transmission.  She was also wondering if she could safely receive oral sex without transmitting HSV1 to someone’s mouth. I’ve read the posts  and it looks like there’s no real data but again from your experience have you ever seen that?

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Back to my original inquiry to Dr. Handsfield’s quote regarding not seeing genital to genital HSV1 transmission to his knowledge - I’m assuming you know that to be an accurate statement? Also, would  you say one is more likely to acquire HSV1  orally from kissing or from performing oral sex on a person with genital HSV1 outside an outbreak? And have you personally diagnosed a person who got oral  HSV1 from performing oral sex? Thanks! 

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Since genital to genital transmission of GHSV1  is so rare and maybe not possible, what is your opinion about disclosing ? People might not understand  that GHSV1 is not  GHSV2 even if you try to tell them - it seems so awkward and maybe not necessary.  I’ve seen the experts on this forum give differing opinions so it’s confusing. Also what dose of Lysine would you recommend? 

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