HSV 1 transmission

[tn8664]

Hi Terri.
I have had a history of vaginal discomfort symptoms that include: pain in urination, itchiness before menstruating. I have been checked head to toe (so I thought) as I have fought this for four years. I have been seen by many doctors, and have been in two monogamous sexual relationships since. They believed it to be Interstitial Cystitis and environmental issues causing this- I have never once experienced a lesion. My previous partner and I were sexually active for 8 months and he never had any problems- no lesions, pain in urination, nothing. my current partner and I have been sexually active for 6 months, and we had oral sex, and then regular vaginal sex about three weeks ago and the next day he had a lesion on the tip of his penis. the days following, more showed up, and we were both very confused. I called my doctor to confirm I had been tested for hsv and he told me that they tested me (twice) by taking my blood for hsv 2 and both times it was negative. since I’ve never had any lesions, they never tested me for hsv 1 because it is so common to have orally apparently. my partner went to get his blood taken and it came back positive for hsv1 and negative for hsv 2. he finally got into see his primary doctor about a week after his lesions appeared and he was told it didn’t really look like herpes, but they took a culture and results came back negative for both hsv 1and hsv 2. my question for you is
1. can we trust that his culture is actually accurate, even though it was taken a week after lesions occurred?
2. should I trust that my vaginal symptoms are truly environmental and not hsv 1? I repeat, I have never had a lesion of any sort. neither did my previous partner, or anyone I have ever had sex with.
3. I do not recall getting cold sores regularly but I have gotten sores inside of my mouth, and around my teeth. and my current partner who tested positive for hsv 1 (blood test) says he had cold sores commonly as a kid.

please advise, thank you.

[Terri Warren]

1. can we trust that his culture is actually accurate, even though it was taken a week after lesions occurred?

No, I do not think you can completely trust the swab test taken a week after lesions appeared, particularly if the swab test was culture and not PCR – you could check on that. But if he had cold sores as a child, then these are unlikely to be HSV 1 and if his antibody test is negative for HSV 2, then I would ask when his last other partner was in relationship to these symptoms. It’s a bit complicated.

2. should I trust that my vaginal symptoms are truly environmental and not hsv 1? I repeat, I have never had a lesion of any sort. neither did my previous partner, or anyone I have ever had sex with.

HSV 1 genitally, for most people, is a quiet disease, rarely recurring. I don’t know what kind of herpes testing either you or your partner had done and that would be important to know. Were they IgG or IgM antibody test? Do you know the index values associated with the test results?

3. I do not recall getting cold sores regularly but I have gotten sores inside of my mouth, and around my teeth. and my current partner who tested positive for hsv 1 (blood test) says he had cold sores commonly as a kid.

Herpes normally causes lesions on the outside of the lips (cold sores) not inside the mouth.

I think we need a little more information before we can make total sense of this.

Terri

[tn8664]

Thanks Terri.
The issue with this all is that he hasn’t had any partners besides me, except one time, two years ago, completely protected. I have been having these vaginal discomfort symptoms for years now, and no lesions have ever appeared. my symptoms don’t really come and go, they just are they but they worsen before my period. I have been tested for hsv 2 twice now, both negative, and he has been tested once, negative. I really don’t think hsv 2 is a possibility, and my doctor agrees.

The hsv 2 test I had done was a IgG and the index value was <.90

my doctor says without me ever having vaginal lesions, he still thinks my symptoms are environmental, (he has also examined me multiple times), but he says he thinks its unlikely but possible for it to be hsv 1 prodome? im not sure what that means. could you specify and then tell me if you agree.

are my symptoms- pain in urination, slight vaginal itching, possibly hsv1 even though ive never had lesions? is it possible to have hsv without ever having a lesion?

I sometimes get zits outside of my mouth, but not really cold sores. I don’t think at least. I had an episode about two months ago where I had sores inside my mouth and around my teeth, and they were very painful, but I assumed it was gingivitis. this was the first time that happened to me.

I would like to know if you think what my partner experienced was hsv1 or “frictional dermatitis” as his doctor proclaimed, and if it was hsv1, how do I know if it came from my mouth or vagina? he really couldn’t have gotten it anywhere else. and I don’t really know where I could have gotten it either unless these symptoms I’ve been having have been hsv 1 all along and all the doctors I have seen have over looked it. (I’ve seen a looooooot of doctors)

thanks for your help Terri.
also, if it is hsv 1, and I do have it genitally, how contagious is it? my partner before my current partner, who hasn’t been with anyone but me, never had symptoms once.

[Terri Warren]

my doctor says without me ever having vaginal lesions, he still thinks my symptoms are environmental, (he has also examined me multiple times), but he says he thinks its unlikely but possible for it to be hsv 1 prodome? im not sure what that means. could you specify and then tell me if you agree.

I agree. Did you actually have HSV 1 antibody testing done? Did I miss that?

are my symptoms- pain in urination, slight vaginal itching, possibly hsv1 even though ive never had lesions? is it possible to have hsv without ever having a lesion?

While it is possible to have HSV 1 without a lesion, absolutely, I’m not thinking that’s what is going on here – your symptoms sound too persistent and too often for HSV 1, in my opinion, and it is just that, an opinion

I sometimes get zits outside of my mouth, but not really cold sores. I don’t think at least. I had an episode about two months ago where I had sores inside my mouth and around my teeth, and they were very painful, but I assumed it was gingivitis. this was the first time that happened to me.

This does not sound like oral herpes to me – much more like canker sores or gingivitis

I would like to know if you think what my partner experienced was hsv1 or “frictional dermatitis” as his doctor proclaimed, and if it was hsv1, how do I know if it came from my mouth or vagina? he really couldn’t have gotten it anywhere else. and I don’t really know where I could have gotten it either unless these symptoms I’ve been having have been hsv 1 all along and all the doctors I have seen have over looked it. (I’ve seen a looooooot of doctors)

The thing that stops me from thinking it is HSV 1 is his history of cold sores. If that history is accurate, then it is extremely unlikely that these were HSV 1 sores.

thanks for your help Terri.

also, if it is hsv 1, and I do have it genitally, how contagious is it? my partner before my current partner, who hasn’t been with anyone but me, never had symptoms once.

HSV 1 recurs and sheds infrequently. Most genital HSV 1 likely comes from oral sex rather than intercourse.

[tn8664]

Thanks Terri. My GYNO doesn’t suggest we test for hsv1 bcecause he said statistically it will be positive because 90% of the population has it. I have been blood tested for hsv 2 twice and always negative. My partner has been blood tested for hsv 1 and 2 and WAS positive for hsv 1 only through blood. Like I said, they took a culture from his lesion after about a week but he said there was one “fresh one” they swabbed from, and it was negative for both hsv 1 and 2.

so from my understanding we can’t completely trust his culture?

Also, I confirmed with my partner and he said his history of cold sores were inside the mouth. And the Same goes for me.

Is the “90% of the population having hsv 1” statistic, referring to cold sores only? Can you have hsv 1 not genitally but not have cold sores?

And if his genital “out break” WAS herpes, and I’ve never have a lesion on my genitAls, only sores inside the mouth and around teeth, how did he get it from me?

Doc says an option would be to treat me for hsv 1 and see if my genital symptoms that I’ve always had go away (pain in urinarion, itchiness). Although, he says its unlikely, like I said he thinks my symptoms are enviromental.

But if they do, and then I do have hsv 1 genitally, for the future, how vital is it to disclose that to future partners? (This is hypothetically- I’m in a happy relationship but we are only 19 so there is a lot of time from here and settling down.

My partner is for the most part content with his culture results being negative. And he says that if his outbreak was hsv 1, his doctor said he would most likely have antibodies to fight it? Do you agree with this? To what extent do the antibodies “fight” it? Can it be basically, cured this way?

Please advise. Thanks so much.

[Terri Warren]

Also, I confirmed with my partner and he said his history of cold sores were inside the mouth. And the Same goes for me.

So those are canker sores, not cold sores – different animal.

Is the “90% of the population having hsv 1” statistic, referring to cold sores only? Can you have hsv 1 not genitally but not have cold sores?

His statistic is incorrect. The proper statistic is that 56% of the US population between the ages of 14 and 49 have HSV 1, far from 90%. If he is positive for HSV 1 already, it is extremely unlikely he would acquire HSV 1 genitally, even if you have it, so there is really no point in testing you at this point, unless you are worried about getting his HSV 1. But even then, the screening test misses 1 out of 4 infections.

And if his genital “out break” WAS herpes, and I’ve never have a lesion on my genitAls, only sores inside the mouth and around teeth, how did he get it from me?
Well, he probably didn’t get this from you.

Doc says an option would be to treat me for hsv 1 and see if my genital symptoms that I’ve always had go away (pain in urinarion, itchiness). Although, he says its unlikely, like I said he thinks my symptoms are enviromental.

I would agree with him on this. HSV 1 genitally as I said is a quiet disease and it would be very unlikely to be causing all these problems for you.

But if they do, and then I do have hsv 1 genitally, for the future, how vital is it to disclose that to future partners? (This is hypothetically- I’m in a happy relationship but we are only 19 so there is a lot of time from here and settling down.

If you do have HSV 1, then I think that is important to disclose to future partner if they have never had a cold sore or test negative for HSV 1.

My partner is for the most part content with his culture results being negative. And he says that if his outbreak was hsv 1, his doctor said he would most likely have antibodies to fight it? Do you agree with this? To what extent do the antibodies “fight” it? Can it be basically, cured this way?

No, it cannot be cured in this way – herpes doesn’t get cured. Again, wasn’t his HSV 1 antibody test positive around the time of the lesions? If yes then the lesions would not be his first infection.

Please advise. Thanks so much.

Terri

[tn8664]

thanks terri.
so if you believe his history of mouth sores are canker sores, does this rule out the chance his hsv 1 is oral?

yes, he was positive for hsv 1 antibodies when he had lesions, so why does this make it unlikely that this was his first infection? do you mean that he likely has hsv 1 orally, or from childhood?

I guess my overall question is, does my partners postivie antibodies test for hsv 1 mean his lesions were hsv 1, or friction?

and with neither of us having cold sores, and me not having genital lesions, does this mean I have hsv 1 genitally, orally, or neither?

Im a bit confused.

when you say, “if he was already postivie for hsv 1, then it Is unlikely he would contract it genitally.” do you mean, if the lesions he has weren’t hsv 1? or do you mean the likely hood of them hsv 1 are low?

and I am concerned of contracting, and having hsv 1 genitally. this is why I am willing to test antibodies for it, but even then, how do I know if I have it genitally or orally without having symptoms?

if my doctor treats me for hsv 1 and my envirmental symptoms don’t go away, is it safe to assume I don’t have it genitally?

[Terri Warren]

With a first infection, a person has no antibody. Antibody is something that you make not something that you get from someone else.

It isn’t possible to know specifically if his lesions are HSV 1 or friction without a swab test of the lesions. He has HSV 1 but were those HSV 1? Can’t know without a swab test.

We can’t know where your HSV 1 infection is if you’ve had no sores – and I’m confused because I thought they didn’t test you for HSV 1? Did I miss that?

While HSV 1 normally presents on the outside of the mouth rather than the inside, without a test we cannot know if you have HSV 1 or not.

Once you have HSV 1 in one location on your body (i.e cold sores) then it is extremely unlikely that one would get HSV 1 in a new location on their body (i.e. genitally).

I’m not sure how to explain this more clearly, perhaps you can help me.

Terri

[tn8664]

Thanks Terri. So the “first infection” refers to first outbreak of sores? Or do you mean like he could have ben Infected by me at the beggining of our relationship, or as a kid, without symptoms?

If the outbreak wasn’t his first infection, but it was his virst visible lesion, does that make a difference in determining if it was genital herpes or not?

His antibody test was postive around the time of the lesions, this doesn’t rule out genital herpes, or give us an answer as to what was causing his lesions?

And you are correct. They did not test me for hsv 1, but I am assuming I have it, because my partner does. We just don’t know where.

So do I just go on without knowing if I have genital herpes or not?

Should I do a blood test for hsv1, but even then if it’s postive, we can’t know if I have it genitally or orally?

[tn8664]

can you have oral herpes hsv 1 without having cold sores?

cab you have genital herpes hsv1 without having lesions ever?

could I have transmitted hsv 1 to him genitally from oral sex, even without a sore present?

could I have transmitted hsv 1 genitally to him from my genitals, even without ever having a sore present?

I am just worried and confused as to where his lesions came from. and eager to know if my “envormental symptoms” are hsv 1.

[Terri Warren]

First infection means the first time he has ever been infected – that is sometimes different than first symptoms. He could have been infected as a child or been infected by your or anyone else with whom he has had sex. It doesn’t make a difference if it was oral or genital no, but if these genital lesions are HSV 1, then his first infection was either genital only or oral and genital at the same time.
No, the antibody test doe not tell us anything about whether the lesions are herpes or not
Yes, if you do take a test and your HSV 1 is positive (know that the screening test misses 27% compared to western blot) you can’t know where your infection is unless you get a lesion that swab tests positive. But if you are positive and so is your partner, for HSV 1, then you don’t need to worry about transmission.
EVen if you have HSV 1 antibody, it does not mean that your difficult symptoms are HSV 1. And yes, you could have given it to him through oral or genital sex from any location (oral or genital) with or without symptoms.

Terri

[tn8664]

Hi Terri,

I recently saw my doctor again to go over what has been going on
as I am very anxious and worried still. I should probably note I suffer from anxiety, pretty severely, so “not knowing” doesn’t exactly set well with me 🙁

although, He still assures me that my symptoms are
environmental, and not herpes. He says this is because my symptoms are
persistent and I’ve never had a lesion. Does this mean I don’t have genital
herpes?

They still haven’t blood tested me for hsv 1 but I am assuming I
have the antibody statistically and because my partner has the antibody.

But
this doesn’t solve the mystery of why my partner showed symptoms of herpes. I
know for a fact he is faithful, so I am wondering if you believe I gave this to
him, and if so is it more likely I gave this to him orally or vaginally?

Or,
if I didn’t give this to him, how did it randomly show up?

I can’t seem to shake the idea that I gave him genital herpes, if it was genital
herpes… Or shake the idea that I may have genital herpes, even though i don’t
have symptoms of it…? I understand there is no way to know for sure without a lesion present, but does it tell us anything that I don’t have any symptoms?

And even so, if his
sores were Hsv 1- is it not true that hsv 1 is kind of hard to transmit genital
to genital? I was reading some comments from The forum, explaining that it’s
transmission genital to genital is extremely low? Can you specify how low or how
unlikely/ or likely it is to transmit hsv 1 this way?

Let me know what else you can give me from all this. I’ve told you all the details now, my doctor
makes it seem like I don’t have much to worry about, but I don’t know how I can go on without knowing where his lesions came from. or I guess, if they came from me.

Thanks Terri. I appreciate what you do on here.

[Terri Warren]

We don’t have a statistic on the frequency of genital to genital or oral to genital transmission of HSV 1. And without a positive swab test from lesions or a positive antibody test for HSV 1 we cannot know if he has HSV 1 or not. Remind me – did he test negative for HSV 1 by antibody test?
Either or both of you can order your own herpes antibody IgG tests online without a provider order if that’s what you want to do. There are many reliable sites that offer this service.

I cannot offer you reassurance because I honestly don’t know what is going on here!
The most reliable test for HSV 1 is the herpes western blot and you may wish to obtain one for yourself to know more about what is going on or not going on. Our clinic can help you with that test.

Terri

[tn8664]

Thanks Terri.

So he tested positive for hsv 1 blood test and negative for hsv2 blood test, but wen they took a swab from the lesions they came back negative for both Hsv 1 and hsv 2. But the problem is the swab was taken about a week after lesions appeared so we don’t know if we can trust it. We know he has hsv 1 we just don’t know where.

I think my doctor is hesitant to blood testing me for hsv 1 because it statically will be positibe, and that would cause me a lot of anxiety over if I have genital herpes or not.

I am willing to test my blood for hsv but if it comes back positive for hsv 1, will the western blot be able to tell me if its genital or oral?

My main concern here is that If he got those lesions from me, if I gave him them genitally. I’m worried that i have genital herpes (Hsv 1) but I’ve never had a lesion, anywhere, so I don’t know how to know this.

His lesions showed up after I performed oral and vaginal sex with him.

is it possible for him to get herpes while in a monogomous relationship with me and me not have it? 🙁

Also could you explain the western blot test further. Thanks so much.
Let me know. Thank you!

[Terri Warren]

So we know he had cold sores as a child so the chances that the lesions genitally are HSV 1 is basically zero. We talked about this in an earlier post at the beginning of our discussion. Once you have HSV 1 in one location you are extremely unlikely to get it in a new location. So let’s take the whole issue of you giving him HSV 1 either from your mouth or your genitals off the table.

So in terms of him, it doesn’t matter if you have HSV 1 or not. If you want to know for yourself for some later partner, the western blot, a more comprehensive blood antibody test, can tell you better than the screening blood test. No blood test can tell you where an infection is, only that you have it.

If you don’t have HSV 2 and he tests negative for HSV 2, then he doesn’t have genital herpes, assuming what he describes as cold sores were cold sores.

Terri

[tn8664]

Thank you!

I was confused though because I clarified with him, and he said that he had sores inside his mouth as a kid- not outside.

Now you said that was a different animal, canker sores.

Does this mean that his outbreak could have been hsv 1?

Or could those sores still have been cold sores?

I had an episode shortly before all this came about where I had a lot of painful sores in my mouth and around my teeth. Does this sound like oral herpes at all?

Hsv2 isnt a possibility here.

Thanks terri.

[Terri Warren]

aaaaargh, I am so confused with this! Yes, that could have been canker sores. So difficult to know. But if his HSV 1 was positive at the time the swab testing was done, that means he had HSV 1 prior to the lesions appearing which means that the lesions are not new HSV 1 if they are HSV 1 at all.
Herpes sores are normally not in the mouth but people do shed from inside the mouth.
In my opinion, you cannot know where his HSV 1 came from, where it is or if you gave it to him or he had it already.

Terri

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