Risk of getting HSV-1

[nathan827]

Hi Terri,

I’d really appreciate your help with a few questions about HSV-1.

1) How worried should I be about HSV-1 in terms of dating and kissing? On the one hand, I hear that nearly half of adults have it, which seems like I shouldn’t be worried. But then, on the other hand, I read about how if you get HSV-1 then give unprotected oral sex, it can transfer to the genitals, which seems a lot worse…

2) Assuming someone with HSV-1 has no visible cold sores on the mouth, how safe is kissing them? And are there any reasonable precautions one can take to avoid getting it?

3) I just found out that someone I’ve kissed several times got tested and has HSV-1 antibodies. Since I’ve read it can live in the mouth but be transferred to the genitals, how would you know which version you have based on that test result (assuming no visible symptoms in either place)?

4) Assuming I’ve already kissed them a few times and haven’t gotten it myself yet, is a fair way to think about it that each time I kiss them again it makes it more and more likely that I’ll contract it?

Thanks so much!

[Terri Warren]

1) How worried should I be about HSV-1 in terms of dating and kissing? On the one hand, I hear that nearly half of adults have it, which seems like I shouldn’t be worried. But then, on the other hand, I read about how if you get HSV-1 then give unprotected oral sex, it can transfer to the genitals, which seems a lot worse…

More than half of adults have HSV 1 infection, actually. If you do have HSV 1 orally and give unprotected oral sex, you can transfer it to the genitals of another person, correct. Not common, but it happens for sure.

2) Assuming someone with HSV-1 has no visible cold sores on the mouth, how safe is kissing them? And are there any reasonable precautions one can take to avoid getting it?

We don’t have any statistics on how safe kissing is with someone who has HSV 1. I would say to avoid kissing someone with a cold sore, for sure.

3) I just found out that someone I’ve kissed several times got tested and has HSV-1 antibodies. Since I’ve read it can live in the mouth but be transferred to the genitals, how would you know which version you have based on that test result (assuming no visible symptoms in either place)?

I don’t understand the question – version? HSV 1 will always be HSV 1 regardless of the location in which it appears. Is that your question?

4) Assuming I’ve already kissed them a few times and haven’t gotten it myself yet, is a fair way to think about it that each time I kiss them again it makes it more and more likely that I’ll contract it?

Well, yes, the more exposures, the more chances there are to contract it. Have you actually been tested yourself? And do you know that the screening test for HSV 1 misses 1 out of 4 infections so a person could test negative on the screening test and there is still a chance they could have HSV 1? The herpes western blot is the gold standard for HSV 1 testing

I personally would not d kiss or not kiss people who display no cold sores based on their antibody status. It seems to me it would be difficult to decide upon whom to kiss based on this because then each person you kiss would need a herpes western blot to be certain they were uninfected with HSV 1, which seems impractical to me. But I know that HSV 1 is more fearful for some than for others. With more than half the population infected, it will be a hard virus to avoid for a life time, I feel.

Terri

Terri

[nathan827]

Thanks very much, Terri! I’ll definitely get tested myself as well, but it wouldn’t be worthwhile to do that until 3 weeks after my potential exposure (i.e., kissing the person who has it), right? It’s my understanding that it has an incubation period before it’s detectable, right?

To clarify my third question: If my partner’s results simply indicated that HSV-1 antibodies were present, couldn’t that mean that HSV-1 is living either in their mouth or on their genitals (e.g., if someone who had it had given them oral sex)? So, assuming no visible symptoms and only the antibodies test result, does that tell you anything about which part of the body the virus might be present in? I’m just wondering since I’d be more careful around the genitals if I knew it were there versus just in their mouth. So, to put it another way, if HSV-1 were in the genitals, would kissing be safe?

[Terri Warren]

If you were our patient, we would order a baseline antibody test to determine if you are currently infected with HSV 1 and don’t know it, then a follow up not at 3 weeks (way too early) but rather at 12 weeks.

A positive HSV 1 antibody test does not tell a person anything about where their infection is if they have never had a cold sore or nasal lesion or genital lesion, correct. If she had genital HSV 1, yes, kissing would be safe.

Terri

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