A culture tested positive for HSV1

Hello, I am a gay 24 yr. old male who had infrequent (maybe 2 or 3 times a year) cold sores.  I recently noticed a weird bump on my butt (the cheek, not the anus...sorry to be graphic), headed to the doctor and had an antibody blood test and culture swab completed.  The results came back and both tested positive for HSV1 which I was pretty sure I already had considering the cold sores I was experiencing.  I know that autoinnoculation is a slim chance, but would I have been able to transmit that?  Likewise, my long term boyfriend was showing no symptoms of any outbreak, and when I had my most recent cold sore, he was actually out of town.  Likewise, we limited kissing and that sort of thing while the outbreak occurred (when he came home, it was healing up).  My question to you is whether or not the swab, though it did report positive for HSV1, simply did so because I have the virus in my body and not because the lesion was caused by HSV1.  Furthermore, if it was caused by HSV1, but did not occur on my genitals, would it be able to develop on my genitals?  I know, lots of questions...I'm just genuinely confused.  Thanks a ton for your help!!!

[gracefromHHP]

A lesion culture doesn't often lie. I would assume you have hsv1 genitally now too. Though we always tell folks that a prior hsv1 oral infection provides you with significant protection against contracting hsv1 on other body parts - we never say it's 100%. There is always the exception to the rule and it appears you are it :(

Has your partner ever had a herpes blood test to know his status? Chances are good that he already has hsv1 since you now have it on a different location ( though it could just be your first obvious recurrence of a prior hsv1 genital infection too ).  If it matters to the 2 of you - get him tested and find out.

As for will you ever get lesions on your actual genitals - well when you contract herpes genitally it infects the entire nerve ganglia in that area so technically you already have the virus there.  You will shed the virus periodically in between obvious ob's from the entire anogenital area - not just from the area that you've had this current lesion at.  does that make any sense?

The herpes handbook at www.westoverheights.com has more info on genital herpes for further reading. Feel free to ask any other questions you might have too :)

grace

[neworldancer]

Thanks...I guess, hahaha...my primary question, which many health officials have been unable to really answer is also how to make sense of the information provided from the test.  Likewise, if I knew I already had HSV1 in my blood stream (via cold sores) and had an outbreak on my lip immediately proceeding what is apparently genital HSV1...would the culture test positive anyway?  That may seem convoluted, but what I'm getting at is...if I had it before, wouldn't a culture for it test positive regardless of where the lesion or wound is herpes related or not?

[neworldancer]

OH...and, I recently spoke with a physician (I'm lucky enough to work with a couple) and he explained that it may actually be herpes gladiatorum which is essentially HSV1 but does not have as much shedding nor do the recurrences happen as often since the infection is outside of its site of preference.  

AND...based on my numbr of OBs in the past (maybe 2 pper year orally and only this one genitally) does suppressive therapy seem a bit premature rather than episodic therapy?

[gracefromHHP]

It's on your butt cheek - it's not herpes gladiatorum - it's genital herpes.

No just because you have hsv1 orally that doesn't mean that a lesion culture of another body part will test + for hsv1. Herpes is not a blood borne virus.  

Once you know your partners hsv1 status you can better decide how to treat your hsv1.  Hsv1 genitally should not reoccur very often for the most part. The handbook goes over it all in more detail.

grace

[neworldancer]

Is it more difficult to pass on genital HSV1 to my partner genitally?  Especially since it sheds less often and does not reoccur as much?  Is it easier to pass genital HSV1 orally?

When you say, should not reoccur very often for the most part, what should I expect the average number of outbreaks to be,,,given that I am a healthy 24 year old male?

Is it likely that, since my partner and I have been monogamous for some time now, that he is HSV1 positive but may have no outbreaks?  Or that he is generally immune to the virus?  I mean, we've had an active sex life and the likelihood he either gave it to me or vice vera seems almost inevitable, would that be a correct assumption?

Thanks so much...you've been an invaluable resource.  I feel like I need to put you on my Christmas card mailing...  :-)

[gracefromHHP]

Did you read the handbook? It answers all the questions you just asked me :)  Your partner should read it too.

grace