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I almost surely contracted genital HSV-1 after having oral HSV-1 for years
Dear Dr. Handsfield -
I'm writing this partly in the hope of getting more information and partly in response to your answer to this question:
http://www.medhelp.org/posts/STDs/HSV-1-Genital-After-HSV-1-Oral/show/1204872
You said that "In addition, there are clinical data: in studies of patients with new genital herpes, new genital HSV-1 has rarely if ever been documented in someone who previously had HSV-1 antibody and/or documented oral herpes." I am not a clinical study but I'm hoping this gets your attention because my case is relevant and also because I'm not sure what steps/precautions I need to take going forward.
I (male) have had oral HSV-1 since I was a young child and probably contracted it vertically through my mother. I know this because I have had infrequent cold sores my whole life and also because of several positive tests for HSV-1 that were conducted in the context of getting tested for HSV-2. I recently started a sexual relationship with a new partner (female) who had not ever had a cold sore or a positive test for HSV-1. We have used condoms every time we have had vaginal intercourse but our oral sex has been unprotected.
Here is where my "statistical_outlier" handle comes from. The first fairly unlikely occurrence was that my partner recently tested positive for genital HSV-1 based on a culture from a lesion near her vagina. Based on the timing, in all likelihood she contracted it from receiving oral sex from me while I was asymptomatic. When I heard about this I had myself tested as well. I had a blood antibody test come up positive for HSV-1, but they also cultured a small lesion that the PA initially assumed was simply an ingrown hair (it did look like one, or a pimple). I'm looking at the results now, and they say:
Culture for Herpes Simplex
Urogenital
Penis
Result: Herpes Simplex Virus Type 1 Isolated
As I said, we used condoms every time we had sex, but the lesion was at the base of my penis, below the region the condom covers. My conclusion based on this information is that I infected my partner with genital HSV-1 through oral sex when I was asymptomatic, and then she very soon after passed the virus back to my penis despite my wearing a condom. Like I said, a very unlikely chain of events.
In addition to bringing this extremely unlikely case to your attention, I have three questions:
1) First, is there any other explanation for isolating HSV-1 from that lesion? They did not cut off a piece of it, but simply poked the surface with a thing like a Q-Tip. What are the chances I could have contaminated the area, say from oral shedding of the virus? I have a sore near my mouth that developed shortly afterward and may be a cold sore.
2) Second, supposing the small sore was caused by herpes, have there been any studies indicating the likelihood of the virus implanting itself in the sacral ganglia (I am certain that it is already latent in my trigeminal ganglia due to my occasional cold sores)? Is there a way for me to know whether this has happened? I'm somewhat hopeful about this since the outbreak, if it can be called that, was extremely minor. The single lesion had no itching, burning or weeping and caused no pain of any kind unless I poked it. I would not have gotten it tested had my partner not had I am specifically curious about my risk of infecting future sexual partners. To what extent should I feel obligated to warn them about this possible infection?
3) Finally, if my partner and I both do now have genital HSV-1, is there any risk to me of spreading the virus to other parts of my penis or testicles from further sexual contact with her? So far my only potential outbreak has been at the base of the penis.
I understand if you don't have the time to answer me in detail but I greatly appreciate any input you might have.
I'm writing this partly in the hope of getting more information and partly in response to your answer to this question:
http://www.medhelp.org/posts/STDs/HSV-1-Genital-After-HSV-1-Oral/show/1204872
You said that "In addition, there are clinical data: in studies of patients with new genital herpes, new genital HSV-1 has rarely if ever been documented in someone who previously had HSV-1 antibody and/or documented oral herpes." I am not a clinical study but I'm hoping this gets your attention because my case is relevant and also because I'm not sure what steps/precautions I need to take going forward.
I (male) have had oral HSV-1 since I was a young child and probably contracted it vertically through my mother. I know this because I have had infrequent cold sores my whole life and also because of several positive tests for HSV-1 that were conducted in the context of getting tested for HSV-2. I recently started a sexual relationship with a new partner (female) who had not ever had a cold sore or a positive test for HSV-1. We have used condoms every time we have had vaginal intercourse but our oral sex has been unprotected.
Here is where my "statistical_outlier" handle comes from. The first fairly unlikely occurrence was that my partner recently tested positive for genital HSV-1 based on a culture from a lesion near her vagina. Based on the timing, in all likelihood she contracted it from receiving oral sex from me while I was asymptomatic. When I heard about this I had myself tested as well. I had a blood antibody test come up positive for HSV-1, but they also cultured a small lesion that the PA initially assumed was simply an ingrown hair (it did look like one, or a pimple). I'm looking at the results now, and they say:
Culture for Herpes Simplex
Urogenital
Penis
Result: Herpes Simplex Virus Type 1 Isolated
As I said, we used condoms every time we had sex, but the lesion was at the base of my penis, below the region the condom covers. My conclusion based on this information is that I infected my partner with genital HSV-1 through oral sex when I was asymptomatic, and then she very soon after passed the virus back to my penis despite my wearing a condom. Like I said, a very unlikely chain of events.
In addition to bringing this extremely unlikely case to your attention, I have three questions:
1) First, is there any other explanation for isolating HSV-1 from that lesion? They did not cut off a piece of it, but simply poked the surface with a thing like a Q-Tip. What are the chances I could have contaminated the area, say from oral shedding of the virus? I have a sore near my mouth that developed shortly afterward and may be a cold sore.
2) Second, supposing the small sore was caused by herpes, have there been any studies indicating the likelihood of the virus implanting itself in the sacral ganglia (I am certain that it is already latent in my trigeminal ganglia due to my occasional cold sores)? Is there a way for me to know whether this has happened? I'm somewhat hopeful about this since the outbreak, if it can be called that, was extremely minor. The single lesion had no itching, burning or weeping and caused no pain of any kind unless I poked it. I would not have gotten it tested had my partner not had I am specifically curious about my risk of infecting future sexual partners. To what extent should I feel obligated to warn them about this possible infection?
3) Finally, if my partner and I both do now have genital HSV-1, is there any risk to me of spreading the virus to other parts of my penis or testicles from further sexual contact with her? So far my only potential outbreak has been at the base of the penis.
I understand if you don't have the time to answer me in detail but I greatly appreciate any input you might have.
I now see that it was moved. Please do delete this as I intend to repost it in the expert community.
I apologize, I was sure I had submitted this to STDs. Not positive what happened. Can a mod please delete this?
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You are reading content posted in the Herpes Community
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
