chances of person with genital hsv-1 contacting oral hsv-1

[trying2dispel]

Hi, I am posting this question to dispel a friend's fear of contracting oral hsv-1.  She contracted genital hsv-1 five years ago.  She has never exhibited oral prodromal symptoms, or a cold sore.  I contracted oral and genital hsv-1 Nov. 2013.  I tested positive for hsv-1 IGg antibodies, and negative for hsv-2 IGg antibodies.  This was a blood test, I didn't have any fluid filled blisters on my genitals to take a swab or culture from.  I only had a rash and redness on my genitals, along with tingling, pain, burning, itching.  I believe I auto-inoculated myself orally by going back and forth between my mouth and genitals with my hand.  I was using my saliva to lubricate my genitals in order to make it erect for better inspecton.  This was 3 weeks after unprotected oral-oral and genital-genital sex with a partner ( who unknown to me at the time ) gets cold sores orally.  I was exhibiting tingling on my genitals, but only suspected a yeast or fungal infection at the time.  I made my partner get tested, who only came back positive for hsv-1.  Obviously I was experiencing a primary infection, I had never had a cold sore in my life.  I believe I gave myself an oral infection prior to having time to produce antibodies.  My question concerns my friend.  Since we both have genital hsv-1, and neither of us are experiencing an initial ( primary ) infection, what are the chances, if any, that I could give her oral hsv-1 if I kissed her?  I have experienced oral prodromal symptoms like tingling and redness around my mouth, but never a full on cold sore.  This usually clears up same day, or within 2 days.  I have never had the fluid filled blisters on my mouth.  Obviously, avoiding kissing during prodromal symptoms would reduce the risk even further, but wouldn't it be very unlikely that I could give it to her, even with prodromal symptoms?  I realize she may already have oral hsv-1 and not know it, since anywhere from 50 - 90%  of the population has it.  Also, I am on daily supressive therapy - acyclovir 400mg,  3 x day.
Thank you in advance,

Trying2dispel

[trying2dispel]

Thank you for your help.  Like you said, whether I have genital or oral hsv-1 shouldn't matter.  I have hsv-1 and so does she.  As long as we are
monogamous, we can't give each other a new infection.  Even if I don't have genital hsv-1, I am not afraid of getting it from her, since I already have antibodies.  She shouldn't worry about getting oral hsv-1 from me, since she already has hsv-1 antibodies, and has a strong immune response established 5 years ago.  I will make sure she reads this.  If she questions your credibility, would you mind listing your training in this area, to help dispel her fears?

Thanks for everything,

Trying 2 dispel

[Fleetwood20]

I really don't mind giving you this food for thought. I do always come from the side of let's prove our way to a herpes diagnosis rather than the other way around.

On that basis, I will pop a few points down as to the evidence of why it isn't herpes such that it can be balanced with your considerations and conclusion at this point that you have genital HSV1.

- The chances are that you have had an oral HSV1 infection since your youth. At least 40% of people with childhood infections do not recall or experience cold sore outbreaks. There is nothing unusual when you suggest perhaps up to 40 years with no oral symptoms. With an established oral infected, a genital infection, regardless of partner's outbreak status, is extremely unlikely.
- There is no evidence that the previous partner have genital HSV1; in fact if she has had cold sores since childhood, she is extremely unlikely to have genital HSV1 regardless of subsequent exposure.
- The timing is out for a primary infection. 2-10 days with an average of 4 is the range. The longer range I have seen at times but believe this refers to people who already have HSV1 and then acquire HSV2 which means quite often there is not an outbreak in the 2-10 day range.
- Yes up to half new genital infections are HSV1, these new genital infections are diagnosed with a positive swab of genital lesions.
- The chance of dual infection is lower than you suggest, the upper limit I've seen quoted is 10-30% (an extreme view). This tends to only occur with several sexual episodes involving oral and vaginal sex.
- You have never been as old as you are today! I'm afraid you will need to get used to experiencing things your body never has before. This will be weird and not so pleasant stuff and I hope it is all manageable.
- Discharge from the eyes is not a sign of herpes, but more likely to be bacterial. Yes our body fights things all the time. It would be fighting a HSV infection a long time before 3 weeks.

[trying2dispel]

Anyway, I do appreciate your help.  When you said that I may not have genital hsv-1, I started thinking: "what if I didn't have it, and then I really got it later in a monogamous relationship?"  Then I remembered that if I am with my friend, who isn't going through a primary infection, then I have nothing to worry about.  I tested pos for hsv-1.  The fact that I had a mild primary infection gave me some doubt if I had it.  But, many people exhibit mild, or no symptoms on their primary infection.  I was also treated for all the bacterial infections with oral and injectible antibiotics, so what else could it be?

Thank you,

Trying2dispel

[trying2dispel]

at the same time she contracted it orally.  Or, she caught it genitally, later in life, from someone who was having a primary infection, due to her antibodies being overdriven by his high viral load.  Like I said, I knew something wasn't right down there 3 wks. after contact.  That is how I gave it to myself orally ( I believe ).  I definitely exhibited something genitally first.  I don't think I had any oral symptoms until January.  I believe I gave it to myself orally before I had antibodies built up.  If you said I could have had an oral hsv-1 infection from my youth, then how could it be that I only exhibited oral stinging, tingling, and redness this year?  I have never experienced anything like that in my entire life.  Never had anything remotely close to that.  Also, I had white discharge coming from the corners of my eyes at  the end of Dec.  I would wipe it away with a Q-tip, only to see more of it in an hour.  I only bring that up because I have never had anything like that in my life; I believe it is proof that my body was battling an infection.  I have read medical websites that say primary infection symptoms can show up anywhere between 2 and 21 days.  Mine were right at, or right under 21 days.  I also read about the back pain in the kidney area, muscle twitching (herpes affects the nervous system), headache ( I never get headaches ), etc. on a medical website. I never got any info from chat rooms.

[trying2dispel]

I whole-heartedly agree with your statement about putting it behind us and
enjoying each other.  However, ( and not that it matters ) , I do believe I contracted genital hsv-1 from that girl.  She did not perform oral sex on me - we only kissed, and had intercourse.  I am not trying to be a hypochondriac, but I had never felt or exhibited those symptoms EVER before on my penis.  I was 42 at the time.  I also got urethritis in February of this year.  Again, I have never experienced anything like that.  I don't remember what the IGg number was, but I think it was around 2 something.  I have read that half of all new genital herpes infections in the U.S. are caused by hsv-1.  I have also read that 50% of people contract hsv-1 orally and genitally at the same time.    Considering that not everyone exhibits acute symptoms upon infection, I believe the girl I had sex with either contracted genital hsv-1

[Fleetwood20]

We really need to search for some clarity here, I think there are a few commonly purported misconceptions at play here. Let's go through a few of the points here.
- if your partner had an oral infection you cannot get genital herpes unless she gave you oral sex
- 3 weeks is not the right timeframe, a primary outbreak for people with no HSV infection will occur 2-10 days after infection
- 5 weeks is enough time for antibodies to appear, if your result was >5 this would probably indicate a much older infection
- it is not possible to diagnose herpes visually
- headache, kidney pain, muscle twitching, eyelid twitching, pain, redness and itching are not suggestive of genital herpes at all

I would not be thinking you gave a genital HSV1 infection at all.

However this isn't terribly relevant to the situation you raise. As you both have HSV1 you both have the same antibodies to fight the virus. This is regardless of location. There are nearly 100 aspects to the immune system response to HSV1 and IgG antibodies are just one of these aspects.

If your partner is reading I hope you both can relax together with this virus. What else could you realistically do? 60% of people you could have a relationship with will have HSV1. For the 40% that don't then there's as much chance of you infecting them and then getting the infection back in another location as someone with HSV1 already!

All of which has a near zero chance in any event. Put this behind you. You both have HSV1, you both have a comprehensive immune response, its time to enjoy each other.

[trying2dispel]

Hi, thank you for your insight.  I had unprotected sex with that girl in Nov.  I had started feeling prodromal symptoms about 3 weeks later - maybe a little sooner, because I dismissed it at first as a yeast infection.  I have had a yeast infection before from a girlfriend.  You usually know it the next day.  This was nothing like a yeast infection.  I guess it was wishful thinking on my part.  I waited 2 more weeks after first noticing symptoms, and went to the clinic.  The nurse practitioner, who used to be a Navy corpsman, said it looked like the rash was a prodromal herpetic infection.  He gave me a rapid HIV test - negative.  Rapid UTI test - negative.  He gave me a shot, and oral doxycycline
anyway - just in case it was syphillis, gonorrea, chlamydia, or some other bacterial infection.  That was also the day that he did the blood draw; it was exactly 5 wks. after sexual contact.  It came back pos for hsv-1.  Five weeks is enough time to produce antibodies, even though they say it can take up to 12  weeks.  I exhibited the classic symptoms of a primary infection - headache, kidney pain, muscle twitching, eyelid twitching.  Pain, redness, and itching on my penis and scrotum.  I also used monostat cream for 2 wks just to make sure it wasn't a yeast infection.  I am sure it is a genital infection, since I have had another genital outbreak.  I understand your position, but I think the girl I had sex with either had genital hsv-1 as a teenager ( that is when she first started getting coldsores ), or, she recently contracted  genital hsv-1 from a guy having a primary infection ( which overdrove her antibodies ) and was experiencing her own asymptomatic primary genital infection.  Of course, she could have had symptoms down there before and lied about it. I guess what matters is that my friend, who I have never touched, is really concerned about getting oral hsv-1 from me if I kiss her.  I can't fault her for being concerned about getting burned again.  Assuming that we both have genital hsv-1, and only I have oral hsv-1, what would you say now about her chances of contracting oral hsv-1 ?  I know we both have antibodies, and neither of us are experiencing a primary infection.  She is concerned that the antibodies for oral hsv-1 are different than the genital hsv-1 antibodies.  I told her they were the same.  Please answer, she will be reading this.  Thank you.

[Fleetwood20]

It is extremely unlikely that you have genital HSV1. When did you have the blood test relative to symptoms appearing? If you had antibodies within days of symptoms, it is more likely you've had an oral HSV1 from your youth. Your partner had an oral HSV1 infection most likely such that you could not get a genital infection without oral sex. With an established oral infection this means you will most likely not get a genital infection owing to the immune system response.

As such I'd suggest that you have an oral infection and she has a genital infection, both now established. This means there is an extremely low chance of further infection for either of you. It's the best combination you could hope for in a relationship when you think about it!