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[janedoe3]

Hi Terri,

I am trying to identify why this dx (genital HSV 1 via blood test and swab) is such a triggering event for me. That being said, I am really struggling. I have now re-read your book, read another book and have read several other questions on this forum. There seem to be some contradictions or at least confusing information.

I am worried that I am infected both orally and genitally. I am already furious with myself for not taking the “just oral” dx more seriously in 2006 because my recent understanding is that it is possible to infect someone genitally via oral sex even if I did not have a cold sore, and I thought I read that most children are infected by casual kisses from asymptomatic relatives. But in your comments to someone else, you said “If you kiss a child and have HSV 1, transmission is close to zero if you have no cold sore”. And I read (in another book – not yours!) that for adults with oral HSV 1, “As long as there are no lesions on the mouth, kissing poses no risk.” (Happy to provide the name of the book if you want it.) So it’s not clear to me what kind of risk is posed by performing oral sex in the absence of a cold sore. And while I know there is no way to know for sure if I am infected both places, but just wondering how common is it for someone with oral HSV 1 to not have any oral symptoms for years or at all (if I am mistaken about the one cold sore) – even when I live in a sunny area and have had lots of dental work, etc. ?

It seems peculiar to me that I have been infected since at least 2006 and this is either my first ob. That would explain the severity but it seems a very long time to go from infection- to first outbreak. I know it’s possible but it just seems odd. In that same other book , it says “if the process of infection is going to produce marked symptoms, it usually starts within 10 days after exposure.” On the other hand, if doc was wrong in 2008, this is my second noticeable ob – in which case it’s worse than the first one, and that seems odd, too. My symptoms started on 12/16 and while my sore has healed, I still have deep burning pain – feels like it is on my cervix. I can’t see any sores there but of course my view is limited. I understand that cervix involvement is less common in subsequent obs. Maybe it is more severe this time because I took Valtrex in 2008 and only took it two days this time?

Finally, you wrote in other posts that “oral HSV 2 is not of much significance, but sometimes people do acquire it in both locations” but also “that if you got HSV 2 orally, you would essentially be vaccinated against getting it genitally.” As you know, I am worried about exposure from my partner and thought that deliberately acquiring HSV 2 orally might be a solution to my anxiety around acquiring it genitally and thus having two types of genital herpes.

Sorry if this is rambling, I don’t even know if I am making sense any more. I know I am over thinking all of this but can’t seem to turn it off.

• This topic was modified 8 years, 2 months ago by janedoe3.

[Terri Warren]

“If you kiss a child and have HSV 1, transmission is close to zero if you have no cold sore”. And I read (in another book – not yours!) that for adults with oral HSV 1, “As long as there are no lesions on the mouth, kissing poses no risk.” (Happy to provide the name of the book if you want it.)

So the way you kiss a child is nothing like how you would kiss a lover with more mucous membrane in the mouth exposed from which shedding can occur. Does that make sense? Giving oral sex to an uninfected person presents some risk because virus can be shed from the inside of the mouth (unlike the thicker skin of the lip).

Lots of people who are infected orally with HSV 1 don’t have outbreaks that they ever remember or notice. Then something immunologic happens and an outbreak emerges. I think you are looking for assurance that you are either infected orally or not I don’t believe you can know that.

I don’t recall what you said was the time between possible infection and your first outbreak. So if there was no risky exposure and then all of a sudden an outbreak more than about 21 days later happens, this was not the first infection, just the first recognized outbreak. Do you see what I am saying?

The Valtrex taken would most certainly have made the first outbreak milder!
I would bet a great deal of money that herpes is not causing (or ever caused) some abnormality on you cervix that is causing deep burning pain. I’m guessing that is something else entirely.

I’m not sure what the question here is:” Finally, you wrote in other posts that “oral HSV 2 is not of much significance, but sometimes people do acquire it in both locations” but also “that if you got HSV 2 orally, you would essentially be vaccinated against getting it genitally.”

Terri

[janedoe3]

That makes sense about the oral shedding, although the book I quoted was referencing adult-to-adult kissing in a foreplay manner. However I am not asking you to explain someone else’s writing. I think I get it. It’s a relief to know I have not exposed the children in my life, at least.

As for the oral infection, I am just trying to understand. In previous comments from you and from what I have read elsewhere, it is unlikely that someone is infected both orally and genitally. You said you doubted my oral HSV 1 status when I could not remember much about having had a cold sore, but it sounds like the absence of cold sores symptoms does not necessarily mean there is no oral HSV 1 infection. I am wondering your thoughts on my never getting a cold sore even with the extensive dental (implants put in, removed, put back in, bone transplant to my jaw, root canals, etc.) and multiple surgeries on my nose. The nose surgeries were not deep – they were to remove basal cell carcinomas and do minor repair. I had minor cosmetic surgery on my eyelids. So I have either never had a cold sore or have not had one for decades, despite lots of sun exposure and facial surgeries. My hope is that suggestive (not confirmation) that the infection is not oral?

As for the time between possible infection – all I know is that I first tested positive for HSV-1 in 2006 or 2007. I was not having symptoms and only got tested as a routine thing, so when they called me with the results, said everything was negative except for HSV-1 and told me it was oral and that I likely caught it as a kid, so I didn’t try to piece together recent exposure. I do know I was sexually active and not in a committed relationship, hence the reason for my wanting to know my status. But I had never been tested prior to 2006 so no way of knowing if it was a new infection.

As for this time – I have had sex twice in the past year – both times with the same person, his status is not known (to me at this time and likely not to him either). The second time which was end of September he performed oral on me, which was the first time anyone has in years. So I know he did not infect me since I tested positive in 2006. But since I have been asymptomatic for so long (either forever or at least since 2008), I can’t help but wonder if he has a slightly different strain and that provoked an OB for me. Or if my previous oral positive was so weak that I was still vulnerable to a genital infection. I know science would probably say no but the science has been wrong with this virus, and what was once “known” is now known to not to be true with many other things. Doesn’t matter I guess and I’ll never know anyway.

My questions in large part are because I need to disclose to my September partner who is also a lifelong friend. He is in an otherwise committed relationship and I know he is faithful to her except for me. I know some people take this kind of thing in stride but my guess he is going to be one of the people who is more upset, at least initially. I want to be as informed as I can be when I talk to him. I feel like he’s going to be getting the worst of news in some ways b/c if he did not know his status prior, never had symptoms and now tests positive, he will have no way of knowing whether it is oral or genital. And of course we’ll have no way of knowing if a positive status is from me or not but that is small comfort to me and will probably be no comfort to him.

Am I understanding correctly that if a NEW ob is going to occur from a recent exposure, it will do so within 21 days of that exposure? If so, is that true for both oral and genital?

My question about the HSV 2 is whether or not it is true that an oral HSV 2 infection will protect against acquiring a new genital HSV 2 infection, as indicated by the second quote, or if it does not, as indicated by the first quote. If it does afford protection, I guess that means that people can have it in both places if they acquire it genitally first, but not if they acquire it orally? Is that then true for HSV 1?

[Terri Warren]

Yes, if symptoms from a new outbreak are going to happen, they are going to happen within 2-21 days, with 21 being very much on the long side. It is true of both oral and genital infection.

I’m not clear that I had the piece that you tested antibody positive in 2006 or 2007, I knew you had what you thought was a cold sore around then.

I know you want me to make some statement about whether you have acquired a new strain of HSV 1 somehow and my statement is no, I do not believe that you have. My opinion is that you may have acquired HSV 1 orally and genitally at the same time (if you do have oral infection which we cannot know despite dental work, surgeries, etc. We do know that your genital outbreak was not your first because temporally it was no where near your most recent sexual exposure.

When you tell your new partner, I hope you will tell him in way that does not paint this as some kind of awful thing. It is a ubiquitous infection for more than half the US population that for most people causes annoying but manageable cold sores. For some, it will cause infrequently recurring genital symptoms usually lasting less than a week. You may bring this up and he’ll tell you he gets cold sores or periodic genital symptoms Until he is tested there’s just no way to know what’s up here.

For your last question on HSV 2: Yes, having oral HSV 2 only will protect against getting HSV 2 genitally, essentially a vaccination. Once a person is infected in one place we believe that essentially protects you from getting it at other places on your body. It is also true for HSV 1. But remember that sometimes people acquire it the first time at both sites. I don’t know what you mean about quotes.

Terri

[janedoe3]

No, did not expect you to say I acquired a new strain. I simply have a theory that exposure to a different strain MAY have provoked an OB in me from my previous existing infection. I know it is not supported by the science right now. I have been told a lot of things about HSV and my body in recent years that have turned out not to be true. I understand now how that happened, that there is new information, that some clinicians are not as knowledgeable as others, that some culture tests can be false-negative. I understand this is a complex virus. And I understand that for me, figuring things out (for example, as to what may provoke an OB) helps me digest and come to terms – even if it is just speculation.

I did tell you a number of times that I had tested positive in 2006 or 2007. I know you get a lot of messages with tons of detail. If I ever had a cold sore, it was long before that – decades ago. So, in sum, I have had:

-possibly one cold sore (many decades ago)
-possibly one noticeable OB in 2008, (seems likely but doctor said symptoms were not herpes-related)
-confirmed via swab genital HSV-1 in 2014.

So this is my first or second noticeable genital OB in 6 or 8 years, with one or no oral obs in several decades. And even though I tested positive for HSV 1 in 2006/7, b/c of what I was told by the doctors, I believed I only had oral. In reality, I really just found out that I have genital herpes a few days ago. So I am still reeling a bit. I think that’s understandable.

Because of my experience, I want to make sure I give the best possible information to my friend when I disclose. My concern about disclosing is based on what I anticipate his response to be, which is based on knowing him. I don’t think he will take it well and my delivery will only have so much influence over that. It’s not like he’s never heard of it. That doesn’t mean I am going to be presenting it as if it is a cancer diagnosis – but let’s be real- it’s not like telling someone they won a raffle prize.

Thanks for your help.

[Terri Warren]

This is what I said about your thoughts that you had acquired a new strain: ” I know you want me to make some statement about whether you have acquired a new strain of HSV 1 somehow and my statement is no, I do not believe that you have”. All I’m saying is that I think you wanted me to make a definitive statement about it, not that you had acquired a new strain.

Yes, when I go to your previous postings I can find information about your testing. When you started a new thread, I didn’t have the old one in front of me anymore to compare.

I think the best information you can give your partner is that he needs to be tested to see if he already has HSV 1 or not. If not, there is a small chance he could acquire this from you. Like you, if he is infected genitally, he will have infrequent recurrences. If he acquires it orally from you, his recurrences will be a little more frequent. But all of that is manageable with medicines. It is also possible that his long term partner has HSV 1 also which puts him a risk. If she has a history of cold sores, he could get it, just like he could get it from you. The irony will be if he tests and finds he is HSV 2 positive. In some ways that would great simplify the picture.

My admonition about telling him is that sometimes the presentation affects how the news is heard.
I’m sure will you do fine. I hope he is also positive so this does not need to be a difficult issue in your relationship in the future.

Terri

[janedoe3]

I am really hoping he is negative for both. We will not be intimate again anyway. I am only telling him so he is advised of the past-tense risk.

Thanks again for your help.

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