[Question #7605] HSV-1 spread through kissing

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55 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.
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Terri Warren, RN, Nurse Practitioner
55 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.

Terri
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53 months ago
How effective would an IgG test be for HSV- 1 and HSV-2   be 7 weeks and 5 days after potential exposure? I used a condom during this encounter and it was no more than a few minutes of sex. My results were negative as opposed to Equivocal or positive. I have never had fluid filled blisters just 5-10 red bumps towards the base of my penis. They are not fluid filled or painful to touch they have just been here for over a week and I am anxious. Thank you.

I have read this report but my test falls at the 8 week mark.
https://cdn.ymaws.com/www.nursepractitionersoforegon.org/resource/collection/4D41C6AF-D26E-4B0C-A76B-B5A2A764C16A/104_NPO_Slides.pdf
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Terri Warren, RN, Nurse Practitioner
52 months ago
We know that at 6 weeks out from a concerning exposure, the test is 70% accurate - that is, if you repeated it at 12 weeks out with a western blot, there is a 70% chance it would remain the same.
If they are simply red bumps, are not painful or tender and are not fluid filled and they aren't really changing, this doesn't sound like herpes to me.  Have you had a clinician look at the bumps?  If not, you really should to get some clarity about them

Terri
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52 months ago
how long from initial presentation do HPV warts take to fully muture
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Terri Warren, RN, Nurse Practitioner
52 months ago
I'm not sure what you mean by fully mature.  Do you mean do they get bigger?  Sometimes they will get bigger.  Sometimes they just stay small.  And they are flesh-colored, not usually red as you describe.

Terri
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52 months ago
Thank you. I meant the point that they stop growing. They are red and small and applying vinegar did turn them white. I am not sure how accurate this vinegar test is
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Terri Warren, RN, Nurse Practitioner
52 months ago
If you have skin lesions that turn white with vinegar, there is an excellent chance they are genital warts, but that test is not 100% accurate.

Terri
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