I believe that her doctor is correct. 40% of new genital herpes in the US is HSV 1, not HSV 2, so that makes sense. If a swab test is positive (but untyped) and the antibody test is positive only for HSV 1, then she only has HSV 1 and the genital lesion must have been HSV 1.
No one has a study showing that if you have HSV 1 in one location that you can't get it in a new one, but I think all experts would agree that it is extremely unlikely. If that was likely to happen, then small children you have cold sores would often get genital infection as well as they touch their mouths and genitals all the time. It is certainly possible to get HSV 1 orally and genitally at the same time, that is, you might kiss someone and receive oral sex from them at the same encounter. But once an immune response is mounted to that type, it is very unlikely you would get it in a new place later.
No one can offer you a guarantee about this. You are going to have to make your decision on the preponderance of professional opinion on this topic. In thirty years of practice, specializing in herpes, I have never seen a patient who has a history of cold sores get new genital HSV 1 infection.
Thank you, but are there any tests that she can take now to re-test if the HSV 1 is in the genital area? I'm guessing that no blood test can distinguish between HSV 1 in the genital area versus HSV 1 in the oral area. How many different "brands" of swab tests are there and are some more accurate than others? And will a genital swab test tell anything significant if there is no genital sore present?
There is no need to re-take a swab test from the genital area. And yes, she needs a lesion present to swab. If the swab test initially was positive, then she has genital HSV 1, period. There are different kinds of swab tests, but their accuracy isn't like the blood tests. If the swab test is positive for HSV from a lesion, then its positive.
We've read that in child birth, the probability of having an outbreak of HSV 1 genital herpes is smaller than HSV 2, but that if the woman gets an HSV 1 genital outbreak during labor the risk of infection to the baby is slightly higher than with HSV 2, My first question is IF there is an HSV 1 genital induced infection of the baby during labor are the actual problems, complications, and treatments to the baby the same as with an HSV 2 infection during labor?
Second, I have read conflicting opinions by "experts" on whether if you have HSV 1 orally you can later contract HSV 1 genitally. Many people in forums say you can't, but I've heard experienced doctors say its possible, has been documented, but rare. Are you aware of any scientific studies that prove this one way or the other?
Thank you for your advice. If you are not aware of any scientific studies on this, what do you personally advise people -- that they can still get HSV 1 gentially even though they have had it orally, or that they can't?
Sorry, I just re-read your first answer, and I guess its that you have never seen a case of it in 30 years. But how would one know most of the time? If someone comes in, gets a genital swab and its HSV 1, and there has never been a prior HSV test, there is no way of knowing. Think of the statistical implications of several studies that say that HSV 1 genital herpes is skyrocketing -- for example this article -- http://journals.lww.com/stdjournal/pages/default.aspx -- says 78% of new genital herpes cases at the colleges tested in 2001 were HSV 1 (up from just 31% 9 years earlier), yet numerous studies say at least 50% of the population tests positive for oral HSV 1 by the age or 20 and has for decades. Studies from the UK and Isreal show even greater increases in HSV 1 genital herpes. Either you can catch HSV 1 genitally despite having it orally, or else all the increase in HSV 1 genital cases is coming only from the half of the population that doesn't test positive for oral. The odds of that are miniscule.
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