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Avatar universal

I have Genital HSV-1 and so does my partner...

I tested positive for ONLY HSV-1 (not hsv2) and to my knowledge have only ever had symptoms on my genitals. My girlfriend also has had symptoms on her genitals, and I am assuming she has HSV-1 there too, although she has not had a definitive hsv1-vs-hsv2 blood test.

1. Is it safe to assume she only has HSV-1 as well? If she has HSV-1 and/or HSV-2 should I be worried about vaginal/oral sex with her?

2. I am wondering if it is possible to transmit my GHSV1 to her mouth via Oral Sex, or her to give it to my mouth via oral sex.

3. If we both have HSV-1 already, is it possible to induce an outbreak on each-other's mouths via oral sex? Or kissing, for that matter?

4. Also, I have read that GHSV1 is unlikely to be transmitted genital-genital, what should my precautions be in the future when it comes to oral sex, and non-oral sex. Assuming my partner has HSV-1 on her mouth, or not at all?

Shortly before our first sexual encounter, I engaged in protected vaginal (non-oral) sex with a stranger. A week later, she engaged in unprotected oral and vaginal sex with someone else. Later the same day, her and I had unprotected vaginal sex for the first time. A few days later we did it again, and both started developing symptoms. A few days before we first had sex, I developed what I believed to be gingivitis. I got a swab done on the sores in my mouth and they came back negative for herpes. It lasted for about a week.

Her physician claims that it came from me because herpes can be transmitted despite the use of condoms, and because she did not display any symptoms on her mouth. (If she contracted it from the other guy, she would have symptoms on her mouth because she gave him oral sex.)

4. Is there any way to really deduce the cause of our disease? I have heard that the likeliness of transmission of genital to genital hsv-1 is low, so I thought it unlikely that I would get it and give it in a weeks time-span.
9 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  Thanks for your question.

First and perhaps most important, what is the evidence your HSV-1 infection is genital?  Most people with positive blood tests for HSV-1 have oral herpes, not genital.  Can you describe your genital herpes symptoms?  Have you been diagnosed with genital herpes by a health professional?

Second and almost as important, you give no evidence your partner has HSV-1.  Tell me more about her symptoms.  Has she had a professional diagnosis of genital herpes?

Even if you have genital HSV-1, you cannot assume your partner has it just because you have had sex with her.  Even after many years of regular sexual contact, genital HSV-1 is usually not transmitted to partners.

You don't say what symptoms you or your partner had after your sexual contact with another partner, except gingivitis -- and the negative HSV test suggests that wasn't herpes.  You may have misunderstood your partner's doctor, or perhaps her doctor doesn't understand herpes or its transmission very well.  Lack of oral symptoms doesn't mean your partner doesn't have oral herpes.  Most people with oral herpes have no symptoms.

I cannot accurately answer most of your questions until these issues are sorted out.  Also, your partner will need to be tested for me to answer properly.  Without that information, here is the best I can do:

1) It isn't safe to assume anything about your partner's HSV status, unless she has had a professional diagnosis and probably lab testing for HSV-1 and HSV-2.

2,4) If you both have HSV-1, you cannot re-infect each other.  People are immune, or at least highly resistant, to new infection (anywhere on the body) with the HSV type they already have.  

3) Sex or kissing do not trigger outbreaks of either HSV-1 or HSV-2.

5) Certainly it is possible to both acquire and then transmit HSV (either HSV-1 or 2) within 3 weeks.  But you haven't given me enough information to know whether it happened in this case.  As best I can tell at this point, probably not.

I hope to be able to help you sort this out. Fill in the missing details and I'll do my best.  However, most likely it will be necessary for your partner to be tested for HSV (both types) and perhaps for you to have additional tests as well.

Best wishes--  HHH, MD

Avatar universal
Hello, I am sorry for the vagueness. We both saw professionals immediately after developing symptoms around the time I indicated.

The initial outbreaks we both experienced were on our genitals. That is how I know that the HSV-1 case is a genital case.

First outbreaks are apparently much worse, and she was in a surmountable amount of pain. She went to a professional and got a test done (which was later positive) but upon being examined the professional told her that it indeed looked like herpes symptoms.

I developed symptoms too. Blisters on the shaft of my penis, painful urination, and I saw a healthcare professional as well. Later I got the blood-test, which turned up positive for HSV-1, and negative for HSV-2. We have been having regular sex since then.

Thank you very much for your help and your quick response.
Avatar universal
To clarify, my partner was diagnosed with herpes and given a test that did NOT differentiate between HSV-1 and 2, I am going to tell her to get that differentiating test ASAP.
239123 tn?1267647614
MEDICAL PROFESSIONAL
OK.  It wasn't initially clear that you both were diagnosed recently.  Relatively severe outbreaks (multiple painful lesions) are consistent with a new infection.  Sorry to hear of that severity -- I hope you (or at least your partner) have been treated with valacyclovir or other anti-herpes drug.

Tell me more about your symptoms.  Was your outbreak as severe as your partner's?  And exactly what kind of test did you have that was positive for HSV-1?  Blood test or swab from a genital lesion?

Same for your partner:  Blood or swab test?  If it was a positive swab test, it should be possible to have it tested to determine virus type.

If your positive test for HSV-1 was a blood test, then it's possible the current problem is HSV-2.  It takes several weeks for HSV blood tests to become positive, so that could reflect an old infection rather than a current new one.
Avatar universal
Once again thank you so much for your advice, I am sorry to have so many questions and simultaneously so few answers for you.

Yes, we both are now taking repressive medication. (On a side note, is it true that taking an increased dosage of acyclovir when you 'feel' an outbreak coming may prevent the outbreak from happening?)

My outbreak was not as severe as my partners, she was apparently in a very large amount of pain. I only had pain peeing and pain from the blisters.

She had a test done at planned parenthood, and doesn't know what specific type she has. I am encouraging her to get a more comprehensive test done, but until that happens I can't know for sure which strand she has. I just assumed it was HSV-1 (like me) because we both developed symptoms around the same time after having sex with each other.

I hadn't thought of HSV 2 not showing, and me having been previously positive for HSV 1... Although I vaguely remember being tested for Herpes about 6 months ago and I THINK I was negative for both strands.

Either way, I will get another blood test done for myself.

I'm sorry I can't give you the information about our specific blood test results until we have them done.

That being said, is it safe to assume that if we both have the same strands of Herpes (1, or 1&2) we are in the clear for oral sex? And unprotected non-oral sex? (You said it is not possible to induce a herpes episode if you already have the strain.)

If we have different strands what does that mean?
239123 tn?1267647614
MEDICAL PROFESSIONAL
So putting this all together, I think you and your partner have new genital herpes due to HSV-2. Most likely you acquired it during the exposure a few weeks ago and promptly transmitted it to your current partner.  This is quite typical:  HSV is most transmissible to new partners during the first few weeks after catching.  HSV-1 is unlikely because your new sexual exposure a few weeks ago was vaginal, not oral -- a risk for HSV-2 but rarely HSV-1.  And I gather you haven't previously had a genital herpes outbreak.  Is that right? So most likely your positive HSV-1 test goes back to a distant past oral infection, not genital.  Finally, people rarely catch new infections with the HSV type they already have. As noted above, it takes several weeks for new HSV infections to give positive blood test results.

This isn't certain, just the most likely scenario. It's really too bad that the Planned Parenthood clinic did not test your partners virus to determine which type it was. I suspect that clinic does not understand the very important differences between genital HSV-1 and 2:  the frequency of recurrent outbreaks, the likelihood of transmission to partners, and the response to treatment all are very different between the two viruses. In fact, knowing the virus type is almost the single most important factor income slang patients and determining the best treatment. Perhaps at a follow-up visit your partner will try to help educate her PP clinic practitioner. Consider printing out this thread is a framework for discussion.

At this point, you and your partner both should have follow-up blood tests for HSV about 6 weeks after start of symptoms; and, depending on the result, again at 12-16 weeks. I predict that you will both have positive results by that time for HSV-2. A possibly quicker way to sort this out would be to arrange a blood test for your partner of a few weeks ago. Most likely she would have a positive result for HSV-2. But since she was "a stranger", I assume this is not likely to happen.

I recommend once your symptoms have cleared up, you and your partner stop taking acyclovir or other anti-HSV drugs, which can interfere with the HSV blood tests. You can always resume suppressive therapy in the future, depending on the frequency or severity of recurrent outbreaks you may or may not have.

Finally, don't worry about reinfecting one another. As noted above, people are immune or highly resistant to new infections with the same HSV type, anywhere on the body. Whichever virus has caused your and your partner's herpes, you will not "ping-pong" the infection back and forth. Avoid sex during obvious outbreaks, but otherwise any sexual activity that you mutually enjoy is okay.
239123 tn?1267647614
MEDICAL PROFESSIONAL
In paragraph 2, "income slang" is supposed to be "in counseling". Please forgive the typo.  (Thanks, Siri!)
Avatar universal
Thank you so much for all your help, I will get those tests done asap.
239123 tn?1267647614
MEDICAL PROFESSIONAL
Glad to have helped.  But one minor change in my advice:  although it is true that partners don't repeatedly reinfect one another with the same virus type, maximum protection by the immune system may take a few months.  While the chance you will infect each other at new sites probably is low even now, for the next few months you should be careful not to perform oral sex on one another if there is any suspicion of a current outbreak.

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