Chances of acquiring ohsv1 after ghsv1

[Shorjump]

Hi Terri,

My partner (now M40) has had oral hsv1 since early university. He gets lip outbreaks a couple times a year depending on stress/sun. He’s had tests that show it’s hsv1, not hsv2.

Before we got together last year, I (F36) had a comprehensive STD test and was negative for both hsv1 and hsv1 (IgG). My partner has always been very vigilant about prodrome symptoms, and whenever he thinks he has an outbreak coming, we’re sure not to kiss or engage in any unsafe behavior until his cold sore is completely healed.

Unfortunately, as we all know, that method is good but not perfect, and asymptomatic shedding does happen. About a month ago, when he felt he had no symptoms, we kissed, had intercourse, and I received oral sex, and a day later, he developed a cold sore, to his surprise. Sure enough, a couple days after that, I developed all the symptoms of genital hsv1. It took me a few days to realize what was going on, but once I did, I took acyclovir 200mg/5xday for 10 days. I did not have any oral symptoms at the same time, and am now about a month out from the day my symptoms first appeared (no recurrences since).

I know that you’ve stated before that once you have one strain of hsv at one location on your body, if you manage not to autoinoculate yourself while you’re developing antibodies, that it becomes unlikely you can spread it to another part of your body. But I’m not sure if that mostly applies to hsv2, or if that also applies to hsv1. I also know that hsv1 much prefers to live above the waist rather than below.

So my question is, since I caught hsv1 in its “less desirable” location where it’s weaker, does this mean I’m less protected against acquiring ohsv1 than I would be if this was the other way around—that I’d acquired ohsv1 and was worried about also acquiring ghsv1? And, once I’ve developed antibodies from this initial infection, what are the chances that I’ll catch ohsv1 from my partner as we continue to live our lives and kiss, share food, etc.?

[Terri Warren]

This also applies to HSV 1. You will likely have few if any recurrences and it is very unlikely that you would subsequently get HSV 1 oral symptoms. During the first few months of infection, I would just be a little more careful about washing your hands after using the rest room and I think you’ll be fine.

Terri

[Shorjump2]

Hi Terri, we had an issue with my account so I made a new one to submit my follow up questions, as discussed. Here they are:

Would you recommend my ohsv1+ partner take daily suppressive antivirals for some amount of time to protect me from an oral infection while I build up my antibodies to my genital infection? And how much would these antivirals reduce the risk of him infecting me orally in the immediate, and long term, future compared to if he didn’t take them?

I took an IgG test 41 days after the encounter that led to my primary OB, and my hsv1 value was positive at 3.22. Does this IgG value mean that even though it hasn’t been four months since exposure (the time I’ve seen mentioned on the forum), that I now already have enough antibodies to be protective against acquiring hsv1 orally? (I did take antivirals during my primary OB for 10 days, I don’t know if that has any negative effect on the development of my antibodies against hsv1.)

Last, I know it’s impossible to know for sure, but since we also obviously kissed during the encounter where I received oral sex and got infected, and I had a symptomatic primary OB on my genitals, but no OB on my face at the same time, what are the odds I contracted the infection in both places, as opposed to just the genitals? It seems like I would have had an OB in both places if I had contracted it in both places (since I had no antibodies at that point and hsv1 loves the face), but I’m not sure what the chances are.

Thank you again for your time and advice! I really appreciate it, and this forum is a godsend.

[Terri Warren]

Oh, you’ve already made antibody then to HSV 1, with a 3.22. So I think you are safe from oral infection from your partner with oral HSV 1
With no oral symptoms, it is unlikely that you also have this orally, but there is simply no way to prove this negative. If you develop a lesion orally, you should have it swab tested but I suspect you may not.

Terri

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