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Aquiring HSV-1 genitally after having it orally
Dr. H,
I previously posed the questions:
1. Can anyone aquire HSV-1 genitally after having it orally?
2. If an individual who has genital HSV-1 has unprotected sex with another individual who has oral HSV-1, will the second individual be at risk for contracting genital HSV-1?
You answered:
"Auto-inoculation of HSV to new body sites only occurs with measurable frequency during the initial infection. Similarly, anybody who is infected with HSV-1 or HSV-1 at any body site is immune from acquiring the same virus type again, at any body site. Your partner will not be at risk for transmitting her genital HSV-1 infection any anatomic site of a future partner who is HSV-1-seropositive."
Herpes.com has a featured article which I recommend at the following link:
http://www.herpes.com/hsv1-2.html
In it, the "expert" writing the article is un-identified but they write:
"By comparison, almost all HSV-2 is encountered after childhood, when people become sexually active. Those who have a prior infection with HSV-1 have an acquired immune response that lowers - though certainly doesn't eliminate-the risk of acquiring HSV-2. According to one study (Mertz, Annals of Internal Medicine,1992), previous oral HSV-1 infection reduces the acquisition of subsequent HSV-2 infection by 40%.
A PRIOR INFECTION with ORAL HSV-1 LOWERS the risk of acquiring GENITAL HSV-1 even further. Studies show that genital HSV-1 infections almost always occur in people who have no prior infection with HSV of either type (Corey, Annals of Internal Medicine, 1983)."
This to me suggests that the concept of aquiring genital HSV-1 AFTER already having orasl HSV-1 is improbable but not absolutely impossible as you suggested. Has this point been settled by research, etc./ or is it a matter of different Infectious Disease experts having different opinions? I would like to believe your advice and not be worried about having unprotected sex with my partner who has genital HSV-1 wheareas I have oral (probably chronic) HSV-1. Is there some, even minor, risk of me cotracting HSV-1 genitally as well?
Thank you!
I previously posed the questions:
1. Can anyone aquire HSV-1 genitally after having it orally?
2. If an individual who has genital HSV-1 has unprotected sex with another individual who has oral HSV-1, will the second individual be at risk for contracting genital HSV-1?
You answered:
"Auto-inoculation of HSV to new body sites only occurs with measurable frequency during the initial infection. Similarly, anybody who is infected with HSV-1 or HSV-1 at any body site is immune from acquiring the same virus type again, at any body site. Your partner will not be at risk for transmitting her genital HSV-1 infection any anatomic site of a future partner who is HSV-1-seropositive."
Herpes.com has a featured article which I recommend at the following link:
http://www.herpes.com/hsv1-2.html
In it, the "expert" writing the article is un-identified but they write:
"By comparison, almost all HSV-2 is encountered after childhood, when people become sexually active. Those who have a prior infection with HSV-1 have an acquired immune response that lowers - though certainly doesn't eliminate-the risk of acquiring HSV-2. According to one study (Mertz, Annals of Internal Medicine,1992), previous oral HSV-1 infection reduces the acquisition of subsequent HSV-2 infection by 40%.
A PRIOR INFECTION with ORAL HSV-1 LOWERS the risk of acquiring GENITAL HSV-1 even further. Studies show that genital HSV-1 infections almost always occur in people who have no prior infection with HSV of either type (Corey, Annals of Internal Medicine, 1983)."
This to me suggests that the concept of aquiring genital HSV-1 AFTER already having orasl HSV-1 is improbable but not absolutely impossible as you suggested. Has this point been settled by research, etc./ or is it a matter of different Infectious Disease experts having different opinions? I would like to believe your advice and not be worried about having unprotected sex with my partner who has genital HSV-1 wheareas I have oral (probably chronic) HSV-1. Is there some, even minor, risk of me cotracting HSV-1 genitally as well?
Thank you!
I don't think that statement contradicts Dr. Handsfield at all. In fact, I think this quote: "...genital HSV-1 infections almost always occur in people who have no prior infection with HSV..." seems to be in complete agreement. I think "almost always" is about as specific as anything you'll ever hear, and seems to me to be standard CYA verbage. I'm sure you're well aware that we're probably the most litigious society on the planet - you're probably reminded of that fact every time you pay your malpractice insurance premiums. Besides, just like in all areas of life, sometimes weird things just happen. No one can possibly say *anything* is 100% true or false. I think you're freaking out way too much over this.
Dr. H, I am not sure why you find my comments inappropriate. I wanted your expert opinion and I brought up an article which (somewhat) dissagrees with a previous comment you made. I do not hold you to "absolutes" and I deferred to you to tell me what you think of the validity of the article I presented. You can delete my questions if you wish...it strikes me as odd that you would be offended by a simple inquiry...I am not challenging your knowledge...quite the contrary I am asking for you to be the decisive opinion. And if I am "splitting hairs" it is because I am worried as I am sure many others writing in this forum are.
I appreciate your point of view and I also think along the same lines as you as far as HSV's overall impact on one's life, especially HSV-1. In terms of my questions and pressing my point, I realize that I am outside of my area of expertise and that doctors (like me) do not usually like to make absolute statements. But there are many things in medicine which are absolute and proven so I just wanted to know what Dr. H thinks. Obviosuly he has all the qualifications and expertise and the article that I quoted may be old news at this point. He may have read it and he can critique in better that anyone else.
I am sure you can also understand that if I do not have genital HSV-1 I would like to avoid having painful sores there...in my mouth, even infrequently, is enough.
Thanks!
I am sure you can also understand that if I do not have genital HSV-1 I would like to avoid having painful sores there...in my mouth, even infrequently, is enough.
Thanks!
I don't think HHH ever explicity said it was "absolutely impossible". That just doesn't sound like anything he ever says. In fact, doctors shy away from ever saying anything is absolutely impossible, right?
You quoted a lot of stuff that is 10-20 years old. Maybe HHH is more current with his knowledge. I don't know much but I think you are overreacting to this. Herpes, compared to the larger scheme of life and illness and bad things that happen to people, isn't a big deal anymore. Especially HSV 1 which he has said over and over doesn't tend to recur like HSV 2. Sorry to butt in being an outsider and all.
You quoted a lot of stuff that is 10-20 years old. Maybe HHH is more current with his knowledge. I don't know much but I think you are overreacting to this. Herpes, compared to the larger scheme of life and illness and bad things that happen to people, isn't a big deal anymore. Especially HSV 1 which he has said over and over doesn't tend to recur like HSV 2. Sorry to butt in being an outsider and all.
MEDICAL PROFESSIONAL
"Inappropriate" isn't the right characterization, and I wasn't at all offended. Just frustration, perhaps, at the number of times on this forum that seemingly definitive advice/conclusions stimulate "yes, but" responses that basically mean "Does that generalization really apply to me?"
As a physician, I'm sure you have counseled many patients to take a course of action, or to interpret a lab test, in a way that they consider definitive, while you are fully aware there are no absolutes and your advice could turn out wrong. In a personal encounter you can do it with first-hand knowledge about the patient's personality, body language, etc. I don't have that luxury. At the same time, most questioners--perhaps including you, but forgive me if I have it wrong--want the same level of nuance they might expect from a personal physician. It just isn't possible, and I get frustrated when questioners seem to want or expect it.
No offense taken and none intended. Regards-- HHH, MD
As a physician, I'm sure you have counseled many patients to take a course of action, or to interpret a lab test, in a way that they consider definitive, while you are fully aware there are no absolutes and your advice could turn out wrong. In a personal encounter you can do it with first-hand knowledge about the patient's personality, body language, etc. I don't have that luxury. At the same time, most questioners--perhaps including you, but forgive me if I have it wrong--want the same level of nuance they might expect from a personal physician. It just isn't possible, and I get frustrated when questioners seem to want or expect it.
No offense taken and none intended. Regards-- HHH, MD
MEDICAL PROFESSIONAL
You need to stop posting comments to previous threads as new ones. Future such attempts will be deleted (without credit card refund). Any further comments should be in this thread; I'm not going to look further at the preceding ones.
You are splitting hairs far too finely and inappropriately. As sussanak said very well, there are few absolutes in biology and medicine. I know the writers of the information from herpes.com, and I am confident they would agree that "lowers still further" is a very conservative statement, because of most scientists' discomfort making absolute statements. To my knowledge, there has never been a virologically documented case of new acquisition of genital HSV-1 in someone with a prior HSV-1 infection at any site. If there are, it occurs rarely enough to justify counseling persons with your concerns to not worry about it.
Nobody should hold my online statements, or those of any online medical source, to the level of precision expected in scientific reports and carefully prepared health information. Further, HSV infections are complex, pathologically, clinically, and epidemiologically. If you look hard enough, you will be able to find all kinds of other "disagreements" betwen experts. It isn't worth your time and energy to find them all.
HHH, MD
You are splitting hairs far too finely and inappropriately. As sussanak said very well, there are few absolutes in biology and medicine. I know the writers of the information from herpes.com, and I am confident they would agree that "lowers still further" is a very conservative statement, because of most scientists' discomfort making absolute statements. To my knowledge, there has never been a virologically documented case of new acquisition of genital HSV-1 in someone with a prior HSV-1 infection at any site. If there are, it occurs rarely enough to justify counseling persons with your concerns to not worry about it.
Nobody should hold my online statements, or those of any online medical source, to the level of precision expected in scientific reports and carefully prepared health information. Further, HSV infections are complex, pathologically, clinically, and epidemiologically. If you look hard enough, you will be able to find all kinds of other "disagreements" betwen experts. It isn't worth your time and energy to find them all.
HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
