As a pre-teen I had oral HSV1, can it morph into genital herpes?

[Need2No]

As a 12 year old, I had a very, very bad case of HSV1 (sores on the top and bottom of my tongue, roof of my mouth, part way down my throat). It was the worst case my pediatrician had ever seen. In my adult life I’ve never had any genital sores until recently. I have had the same partner for the past 8 months and we are monogamous, and no sexual partners for 3 years prior to that (gun shy after a divorce). He has never had or been diagnosed with HSV1 or 2 and is completely asymptomatic currently. I went into my doc to see what was the issue. I thought my two sores might be some type of vulvar cyst. I shave on occasion, but not in the region where these lumps are located. They initially itched and were tender to the touch but after a few days of sit baths, the itching is not as bad. The doc asked if I had ever had cold sores and if I’d had any genital sores (which was yes for cold sores and no for genital sores). She ordered a blood IgG test for HSV1 and 2 and was doing some type of culture (I do not know if it was a PCR typing). My question is that if my boyfriend is completely asymptomatic (no oral sores or genital lesions), how can this possibly be HSV? What other type of disorder could it be?

[Terri Warren]

The problem is that 80% of those infected with HSV 2 are asymptomatic but can transmit virus to someone else. Did the doctor think these bumps looked like herpes? Has your partner actually ever had a herpes antibody test like the one your doctor ordered? Without being able to see you in person, I can’t know the nature or origin of your bumps, but I would strongly suggest that if your partner has not had an IgG antibody test for HSV 1 and 2, you can’t know what your risks are here or his risks of acquiring HSV 1 from you. He can obtain this test online without a clinician order. Remember that you only want IgG testing, not IgM, for him. Let me know the results of the swab test.

Terri

[Need2No]

Terri,

So my results are in. The IgG test was definitive for HSV1 and not for HSV2. The swab test came back positive for herpes. So I now know that I in fact have HSV1 genital herpes. I’m perplexed at how it was contracted. I’ve been in a monogamous relationship (neither one of us has had any other partner for a long time). My partner was not symptomatic and never has any lesions (oral or genital). I, in the past have had oral herpes outbreak … terrible cold sores, but have not had any for over a year. Is it at all possible to contract HSV1 from me giving my partner oral sex, and then engaging in vaginal sex even though I was not symptomatic? Or could it be that he has HSV1, but does not show symptoms. I realize that there had an exchange of viral material, but I’m not certain how it occurred. I do realize that there is viral sloughing when someone is asymptomatic, but again when he’s never had a cold sore or genital sore, I’m perplexed.

[Terri Warren]

Do you know the exact index value for the HSV 2? Has your boyfriend actually been tested for herpes antibody? It would be highly unlikely (though not impossible) for you to contract HSV 1 genitally after having it orally as a preteen.

If you had newly acquired HSV 2 from an asymptomatic partner, you would not yet have HSV 2 antibody.

If you were my patient, I would ask that your partner be tested for IgG antibody and see what he has and then try to make more sense of this. Remember that 80% of those infected with HSV 2 are not aware they are infected and may have no symptoms. Is he resistant to being tested?

Terri

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