OH MY GOODNESS...

[possible_exception]

I have HSV I.  I have reoccurring cold sores appearing on my lips, and have gotten them since I was a little girl.  They are brought on by stress and sunlight.  I once was given an oral (400mg dose, taken 4times daily) when outbreaks occur.  I am not and have not been sexually active, but have touched myself vaginally while having a cold sore outbreak.  

Three years ago I noticed vaginal itching, and while showering discovered a fluid filled vesicle (I believe) on one of my outer labia.  I went to a MD, and she didn't swab or look at it but trusted my judgment that it was HSV I, transferred genitally by autoinoculation.

Since then, I have maybe experienced two or three genital outbreaks, where I have genital itching, swollen sore lymph nodes on my groin, lower back ache, and have one  to two sores.  These sores have not been as bad as the first one, so it or they are not usually fluid filled, but more open sores, or scabbed over. (making it hard to go in for a possible swab).  

I went and had a bld test, and tested positive for HSV1, and negative for HSV2.  

Well, sounds like genital HSV I herpes to me...

BUT HOW?

MAJOR QUESTON:  If I have the antibodies, which I do because of my history of having them since I was little, then it transferred even with me having the Antibodies?  

ADDED STRESS:
I am getting married soon. And discussing this with him is hard, when I have no answers myself.

He has never gotten a cold sore.  We have kissed while I have had cold sores.  

RECAP:
BIGGEST QUESTIONS:  
Is it possible?
Am I the only person that you have ever heard this happened to?

IF IT IS POSSILBE:
I need to know about transferring this to him?
What it means to have a reoccurring HSV 1 infection genitally?  Is this WORSE?
Appropriate treatment?
How this will effect having children?

[possible_exception]

THANK YOU!!!

[Edward W Hook, MD]

I can give you some answers and some educated guesses.  Unfortunately, genital HSV-1 is not very well studied so we know much more about HSV-2 than HSV-1.  Here goes:

1.  Best case/worse case - you've got it correct
2.  If he has antibodies,  any sex is very safe.  If not, if  your genital lesions are herpes (remember, you still don't know this - you have never had a culture and other dermatological conditions can cause small blisters), you could transmit to him through oral sex or genital sex if unprotected.  Most likely to occur if you had a cold sore, very small chance for oral if you do not.  Similar advice regarding genital although there is less known about this form of infection and, once again, you don't know if your lesions were herpes (admittedly, it does sound that way).
3.  Nothing to suggest that recurring genital HSV-1 is worse.
4.  Appropriate treatment.  No studies.  Best thing- a blood test for him.  If he does not have antibodies or if you don't know, best advice is condoms and, logically but unstudied- valacyclovir suppression for you - I would go with the higher suppressive dose - 1.0g per day.
5.  Effect on children - odds of transmission from you to your baby- tiny if no suppressive therapy, even lower if suppressed.

Bottom line, much conjecture here.  To really have an idea, he needs to have a gG specific blood test.  EWH

[possible_exception]

Thank you.  Now that I've heard from a medical stand point that it is possible although extremely rare, I can start dealing with it.  PLEASE HELP!

First, I am in a one time, long term marriage, and we are each others only partners, so...
Best Case:  He has the AB, does that mean he won't get it from me, genitally or orally?
Worst Case:  He doesn't, wouldn't we want him to get it orally, have the AB, so he less of a chance getting it genitally.
I need to know about transferring this to him? Can we have sex, oral sex,  not use condoms, and be considered safe as long as we do it when I don't have an outbreak.
(He doesn't ever want to use condoms).

What it means to have a reoccurring HSV 1 infection genitally?  Is this WORSE, the fact that it reoccurs?

Appropriate treatment? Should I be on a prophyllactic dose of something?  For less chance of transmission?  Honeymoon, etc.

How this will effect having children? Will we only have to be concerned on the slight chance that I get a sore around the time of delivery, in which case I would have a c/s?

Thank you.

[Edward W Hook, MD]

Is it possible to inoculate yourself with HSV-1, mouth to genitals?- yes.  How often?  Very rare--typically your body's immune response (antibodies) to the oral infection makes auto-inoculation very rare.  It certainly does happen however - the protection is not perfect.  Similarly, genital recurrences of HSV-1 do occur but once again, clearly less often than for HSV-2.  HSV-2 typically recurs 4-6 times per year and more frequently is not unusual.

You have not (to your knowledge) given him your infection despite kissing - so what's up there.  Two possibilities, he got it without an outbreak or already has it (if he has HSV-1 antibodies, you'll never know which occurred - remember, over 60% of adults have had HSV-1), or you've been lucky so far.  No way to know for sure but an antibody test for him would help you guys either way.

Are you the only one this has ever happened to?  No way--many occurrences.  Unfortunately however, not well studied because it is rare.

Hope this helps.  EWH