16 year marriage, husband hsv1+ orally since childhood. I tested +ghsv1 from a vaginal swab this week. IGG 1 & 2 were negative, so this is a new infection from oral sex w/o an active outbreak from him.

1. My ob said it was likely contracted because we both had covid in March and then received our vaccines in April/May. She believes our immune systems were weak, is this probable? 

2. Since our case is oral to genital from him, and now we are both positive, how unlikely is it that I will pass it to his genitals or he to my mouth?

3. Will sexual contact with me if I am unknowingly active or shedding cause him to have an active outbreak or vice versa? 

4. When is it safe to have sex after an outbreak?

5. I have SLE. Are there any complications I need to be aware of. Will I potentially have more outbreaks than normal? 

since the IgG test misses 30% of HSV 1 infections compared to the gold standard western blot for herpes, I would not be so certain this is a new infection.  Did you have multiple lesions on both sides of the labia or was the outbreak more limited?

1.  There is zero evidence for this opinion

2.  Once you have a well established infection in one location, it would be extremely unlikely to get the same type in a new location.  IF your infection is new, it might take a couple of months for it to be well established.

3.  No

4.  Well, I think we've covered that a bit in the above questions.  But you should know that it is possible to give off virus even when you don't have an outbreak so the answer is we just don't know when it is safe.  But if you are only having sex with your husband, I don't think this is an issue.

5.  I don't anticipate you'll have more trouble with HSV 1 than anyone else, honestly.  Genital HSV 1 is such a benign infection for the majority of people who have it, I think you are going to be just fine.

Terri

Thank you for responding. My husband performed oral sex on me and then about 4 days later I noticed a very small bump on my right labia, my husband said it looked like an ingrown hair. The next day it looked like a cut, it was directly on a fold and became painful and then the day after that it turned into a dime sized ulcer, primarily hurt during urination. A few days later I developed a low grade fever, headache and body aches, I thought maybe it was lupus but it didn't feel like my usual lupus. The next day I had burning and itching on my left labia, was awful to use the bathroom, so I made the appointment with my OB.  She noticed that there were several blisters on my left labia and said it looked like herpes. She swabbed both the left and right and the swab obviously confirmed hsv1. The blisters have turned into a few ulcers and now seem to be healing.

1. Does this sound like a first outbreak? I am about 3 weeks out from first symptoms and am finally feeling like things are almost healed. I have been on valacyclovir since last Wednesday.  I have never had anything like this before.

2. So, in our situation, are condoms even necessary? Or should we use them during the next 6 months or maybe 2 years until shedding lessens? I am assuming taking valacyclovir daily is way overboard given our situation. 

4. This one is in my head I am thinking, but I need reassurance before I swim with my kids this summer. Swimming in a chlorinated pool, even with an active outbreak, absolutely will not spread this to others? 

I am so thankful to have reassurance and answers from experts, so thank you. It doesn't sound like hsv1 is a huge deal for most people, I have been through worse, but it has definitely affected my mental health, especially the stigma attached to it. Having accurate, reliable information is so important so I can accept this and move on. 

1. Does this sound like a first outbreak? I am about 3 weeks out from first symptoms and am finally feeling like things are almost healed. I have been on valacyclovir since last Wednesday.  I have never had anything like this before.

It does SOUND like a new infection yes

2. So, in our situation, are condoms even necessary? Or should we use them during the next 6 months or maybe 2 years until shedding lessens? I am assuming taking valacyclovir daily is way overboard given our situation.

No, I don't think that condoms are necessary.  IF this is truly a new infection, he has established HSV 1 infection orally and is very very unlikely to get HSV 1 genitally subsequently.

4. This one is in my head I am thinking, but I need reassurance before I swim with my kids this summer. Swimming in a chlorinated pool, even with an active outbreak, absolutely will not spread this to others?

Absolutely not.

I am so thankful to have reassurance and answers from experts, so thank you. It doesn't sound like hsv1 is a huge deal for most people, I have been through worse, but it has definitely affected my mental health, especially the stigma attached to it. Having accurate, reliable information is so important so I can accept this and move on.

You acquired this in the context of a monogomous relationship making love with your own husband.  This happens all the time and you should feel zero shame.  In time, I believe your mind will grasp that fully.

Terri

Even though everything seemed to heal do you believe this is still the initial outbreak since I never stopped itching? Or is it a recurrent outbreak less than a week later?

Is it normal to have multiple episodes of new sores through the initial outbreak? 

My doctor called in another prescription of Valacyclovir but a lower dose meant for repeat outbreaks.  If this is still the initial outbreak, should I be taking a higher dose? Or because I have had 3 separate outbreaks within the initial outbreak, should I consider taking medication daily for a few months? 

If you were my patient, I would put you on suppression for 6 months to try to settle the virus down a bit.  You certainly are a candidate for daily suppression now.  I hope you will discuss this option with your doctor.   I'm so sorry you are having such difficulty with this.

Terri