Hsv1/hsv 2

[Scorgan]

Hi Doctor -

So I started dating this guy a few weeks ago (I am a gay male) and he mentioned on different occasions that he has hsv1 and then mentioned his ex has anal hsv1 and I know they dated a long time and stopped using protection.  Is it possible for the guy I am dating to have both oral and genital hsv1?   I m
Not sure when the guy I am dating found out he had hsv1 but if the guy I am seeing had oral hsv1 before dating this guy with genital hsv1, would he not be able to get genital hsv1? Also having a prior hsv1 infection, does that offer protection against contrcting hsv2? I think I have read it may offer some protection? Would it probably make any hsv2 symptoms less severe? Thanks!

[Edward W Hook, MD]

As the saying goes "stuff happens" and with science and humans there are no absolutes but the risk of your getting HSV-1 during sex with yoru partner, even if he has an active outbreak, is negligible and not something to be worried about.  Further, if he has anal HSV-1, statistically, his risk of even having a recurrence is low. Studies indicatte that ano-genital HSV-1 is less likely to recur than HSV-2 at the same sites.

The keys to avoiding transmission by those who know they have it have been proven to be avoiding sex during outbreaks and prodromes, using daily suppressive antiviral therapy and telling your partner of your infection.  For those with an infected partner, the key from that perspective is condoms and having an engaged partner who employees the measures mentioned aboe.  EWH

[Scorgan]

Hi Doctor -

Great thanks for the reply.  I believe I have had cold sores before so I am goign to assume that I have oral HSV1.  So if my partner was having an anal outbreak of HSV1 and we had unprotected sex, I wouldnt get genital HSV1?  I have read many things on this but it still confuses me at times.  I also know that most people do not even know they have genital HSV2 and even for those that get outbreaks, I have read that avoiding sex during prodrome and outbreaks, your chances of transmission are very small, is that accurate as well?

Thank you...

[Edward W Hook, MD]

Welcome to the Forum.  Your questions are good ones. Before I address them, I note that you do not mention whether you have HSV-1 or not.  The odds are a little better than 50/50 that you do have HSV-1 already. I say this on the basis of the fact that over 60% of American adults have HSV-1 and most of those people do not know that they have it (we know this from tests for antibodies performed on representative samples of the U.S. population).  

Now for your questions.

Although it happens, it is very unusual for person to have any HSV infection at more than one site. Thus when someone has HSV-1 at one site (the mouth or the rectum), then their body's immune system keeps them from becoming infected at other sites.  Further, persons who already have HSV-1 are highly resistant to repeat infection and thus do not need to worry about getting HSV-1 from another partner or at another site.  

The research studies do suggest that when persons have HSV-1, they are somewhat, but not completely resistant to further infection with HSV-2.  The presence of HSV-1 may also make HSV-2 symptoms somewhat milder if they acquire HSV-2 but again, the data on this are not absolute and there is some debate as to how much prior infection with one virus may modify the symptoms of the other.

I hope these answers are helpful to you.  EWH