[Question #7605] HSV-1 spread through kissing

1 months ago
I have been seeing a woman for a few weeks now I just learned that she gets cold sores. We have kissed many times. She claims she got the virus as a child and only gets sores once a year when she is stressed and can feel when they are coming on. She takes valtrex to control her outbreaks, but does not take it daily.

I am wondering what is my risk for contracting HSV-1 through kissing when there are no visible sores? I have tested negative for the virus on my last STD panel. I know it is impossible to perfectly quantify my risk, but I am wondering how likely am I to get the virus if she and I are together for potentially months and constantly kissing. I no cold sores are not a big deal but I would prefer not to get them. I do not want to end this relationship over being paranoid. This paper makes it seem somewhat likely I could contract the virus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200985/   Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago
We don't have specific data on transmission through kissing.  And I am familiar with the article that you cite.  The thing is, the presence of virus is only factor in transmission.  It's tempting to think that every time virus is present, transmission happens, but that isn't correct.  The uninfected person must have vulnerability in terms of vulnerable tissue, their immune system's response to virus exposure, just many things.  I would also say to you that the IgG test misses 30% of HSV 1 infections compared to the gold standard herpes western blot.  So it's possible that you may be infected and not know it.  I'm not saying you do, just telling you about the sensitivity of the IgG test for HSV 1. 

We also know that people who have infrequent recurrences shed virus less often than those who have more frequent recurrences. 
You two could discuss your concerns a bit more and see if she would be interested in taking daily antiviral medication.
About 47% of the population has HSV 1 infection and about 70% of them don't know they are infected.  I suspect you've kissed others who are HSV 1 positive though they may or may not have known they are infected. 

Please let me know what other questions you may have.