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Genital HSV 1 with prior oral infection

I'm interested in getting feedback from people who have some medical expertise on herpes infection and autoimmunity.

Long story short, I had a sex with a partner who, exactly one week later, developed herpes lesions on her labia.  While we both waited for STD test results to come back, I read everything I could on herpes. From what I gathered, most experts believe it is impossible to contract genital hsv 1 with a prior oral hsv 1, due to the antibodies already present from the oral infection. I was extremely worried, as I knew that we both had oral hsv 1 through antibody tests and, with her, recurrent cold sores over the last several years. I started to suspect that this was a hsv 2 infection that I had contracted unknowingly (from a previous partner who didn't apparently know or neglected to inform me) and passed on to this partner.

But yesterday, her lesion swab results came back positive for type 1 only, and her doctor didn't seem the least surprised given the minor severity of the outbreak. My blood tests came back negative for hsv 2, which means that I didn't have a prior hsv 2 infection. I'm relieved, and I've never had any herpes symptoms on my genitals or mouth. However, my current partner has had recurrent cold sores, especially within the last few months when she has gone off and on birth control. I'm wondering if perhaps this was a self-infection passed from her mouth to my genitals and then hers since I did not perform oral sex on her.

My question is this: isn't this an incredibly rare situation? Shouldn't she have been immune to genital hsv 1? Could this be a sign that she has some sort of autoimmunity disease?

Thanks for any help you can provide.
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Avatar universal
Thanks again for your opinion. I'm not asking for my own health concerns--I've never had an outbreak that I can remember.

This is more psychological and deals with my relationship with my partner. Although we are no longer married, we have a child and have a good working relationship, and will continue to have one. But I can see this as a future issue getting thrown up by her--that I "infected" her. I was looking for more proof that this couldn't be the case. But I suppose the problems here are deeper, and regardless of the actual transmission vector, it's those underlying issues that will need to be addressed.

Thanks again.
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Avatar universal
As a male, it is incredibly unlikely for you to have a genital HSV1 infection given an established oral infection.

I suspect that it is marginally more likely for a female to be infected genitally given an established oral HSV1 infection but this still remains highly unlikely.

The chances of you having genital HSV1, followed by actually passing it to someone with an established oral infection via vaginal sex are incredibly low.

It follows that it remains much more likely that your partner was infected in both locations in a small timeframe previously. Does she remember anything about the HSV1 infection, does she remember primary outbreaks genitally and orally?

I guess the other issue is, what does all of this really matter? This is a highly common virus that you both have that may give rise to sores from time to time. There isn't really anything to be gained by giving it much thought at all... don't you think?
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Avatar universal
Thanks for answering. My partner just had a recurrence, and now I am left with another question.

It's possible that I am infected both genitally and orally without showing any apparent symptoms. But is it also possible that I could have passed genital hsv 1 to my partner even though she had a prior oral infection?

I understand that many experts believe you develop immunity to each type of hsv once infected, but I have also read that some physicians report diagnosing primary genital hsv 1 in patients who had a prior oral infection. Although rare, they contend it happens. And if this is the case, then I suppose there is no way to know with certainty whether I transmitted genital hsv 1 to my partner or she already had an infection in that location but never had an apparent genital outbreak until recently.
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Avatar universal
There are far more likely possibilities than self inoculation. These are:
- that your partner was infected genitally in the past and does not have an oral infection, the sores being staph or some other condition; or
- that your partner was infected in the past in both the oral and genital locations in a small timeframe before the immune system kicked in.

Unless both these possibilities can be eliminated, they remain strong explanations of your partner's situation.
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