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Genital HSV-1 Asymptomatic Shedding
My girlfriend of 4 months has confided in me a medical condition that she was under the impression was of very minimal consequence, and i'm not so sure. She contracted hsv-1 as a 2 year old infant her genital area (contact with a cold sore and autoinoculation). She was not infected on her vagina, but instead in the area directly around, on her thighs, and the space behind and up to her rectum. Her parents through medical advisement of the time, never informed her of her condition. 13 years later she had her first and only outbreak, for about 5 days, was treated and it subsided. This is when she was informed of her condition (complete shock, obviously). Her doctors said through various factors of her case, that she could not transmit her virus unless she had symptoms. Her parents assured her this was correct, and therefore it became her decision whether or not she wanted to disclose the information to future partners. She has not had another recurrence since then, which was 4 years ago. Through my own research and discussion with a dermatologist, I have become aware of the asymptomatic shedding associated with the herpes simplex virus. However, I also realize that recurrence is directly related to viral shedding.
I am very concerned for my own health, but I also care deeply for the girl and would like to find a way to stay with her without risking my own sanity over my health.
My questions would be I suppose:
1) What are the chances of me catching this infection
2) Are there some people who do not shed asymptomatically at all?
3) And is there a chance that her case is so abnormal as to not be considered on the same level as most of the hsv-1 cases I have seen previously on the internet
Thank you very much.
I am very concerned for my own health, but I also care deeply for the girl and would like to find a way to stay with her without risking my own sanity over my health.
My questions would be I suppose:
1) What are the chances of me catching this infection
2) Are there some people who do not shed asymptomatically at all?
3) And is there a chance that her case is so abnormal as to not be considered on the same level as most of the hsv-1 cases I have seen previously on the internet
Thank you very much.
My apologies
MEDICAL PROFESSIONAL
I have no further comments on this thread.
If HSV1 is difficult to transmit genitally, and even if it does occur, if oral to genital transmission is so much more frequent, then why would people ever tell another person WHERE they got this infection? I would certainly tell someone I got a cold sore and could possibly give that to them, but if oral is much more likely means of transmission, why would you divulge where your specific infection was? If they love you enough to have sex with you, then I don't imagine they would restrict which body part they could contact and which to avoid.
MEDICAL PROFESSIONAL
Recurrent genital HSV-1 is uncommon compared with HSV-2, and there isn't much asymptomatic shedding of the virus. Those facts have to translate into less frequent genital-genital transmission than for HSV-2. I have never said it cannot occur, but is appears to be uncommon.
Why do you believe that HSV 1 genital to genital transmission is unlikely? I recently got it, and I believe there are a LOT of people getting HSV-1 genital to genital.
In theory - at least 1 out of every 3 girls in what I'm assuming is your age group has hsv1 orally. I'm betting you really haven't given it a 2nd thought before making out with anyone ever have you? Don't get hung up on this just because it's below the belt. It's more likely to be transmitted from the oral area to the oral area than it is from genitals to genitals with hsv1.
I'm totally with HHH that herpes really shouldn't be much of an issue when considering whether to be in a long term committed relationship with someone - whether it's 3 months or 3 years or 30 years you are hoping to spend together. Precautions really do work to reduce your chances of contracting the virus from someone. Studies have even shown that you are safer with someone who knows they have genital herpes than with someone who isn't aware of their infection. Very few of us make it to the old age home without herpes simplex of one type of the other in at least 1 location. it's THAT common. Oh yes I understand I'm a little biased about all this since I have hsv1 orally and hsv2 genitally but you know the older you get, the more baggage you carry around with you from relationship to relationship and most of it is far, far worse to deal with than something as common as herpes is. A cold sore pops up - you pop a few antivirals, spread some goop on your lips several times a day for a few days and ta da before you know it is gone. The psychological damage you had inflicted on you by parents and ex partners - that's there day after day after day.
I understand your moral quandry about the testing but once you've made your decision to stay in the relationship - then go get tested so you two can make educated decisions about what precautions, if any, are needed in the relationship. Wouldn't it be ironic though if you felt this was something big enough to make it worth walking away from and then got yourself tested and found out you too had hsv1 but were part of the majority who have it who don't get obvious cold sores to know it?
grace
I'm totally with HHH that herpes really shouldn't be much of an issue when considering whether to be in a long term committed relationship with someone - whether it's 3 months or 3 years or 30 years you are hoping to spend together. Precautions really do work to reduce your chances of contracting the virus from someone. Studies have even shown that you are safer with someone who knows they have genital herpes than with someone who isn't aware of their infection. Very few of us make it to the old age home without herpes simplex of one type of the other in at least 1 location. it's THAT common. Oh yes I understand I'm a little biased about all this since I have hsv1 orally and hsv2 genitally but you know the older you get, the more baggage you carry around with you from relationship to relationship and most of it is far, far worse to deal with than something as common as herpes is. A cold sore pops up - you pop a few antivirals, spread some goop on your lips several times a day for a few days and ta da before you know it is gone. The psychological damage you had inflicted on you by parents and ex partners - that's there day after day after day.
I understand your moral quandry about the testing but once you've made your decision to stay in the relationship - then go get tested so you two can make educated decisions about what precautions, if any, are needed in the relationship. Wouldn't it be ironic though if you felt this was something big enough to make it worth walking away from and then got yourself tested and found out you too had hsv1 but were part of the majority who have it who don't get obvious cold sores to know it?
grace
MEDICAL PROFESSIONAL
Preexisting skin lesions presumably would increase the risk of catching HSV if exposed, but certainly HSV can infect normal, intact skin.
There is no evidence that healthy people are any less likely to acquire HSV than people with chronic illness or other immune deficiencies. (Overtly immunodeficient people, e.g. those with HIV, can get more severe symptoms, but there is no evidence that they are more susceptible to HSV infection.)
There is no evidence that healthy people are any less likely to acquire HSV than people with chronic illness or other immune deficiencies. (Overtly immunodeficient people, e.g. those with HIV, can get more severe symptoms, but there is no evidence that they are more susceptible to HSV infection.)
Thank you for your time in answering my questions. I guess I have a few moral implications with all of this as well. I wouldn't want a type specific blood test to tell me whether or not I had already been exposed, to use that to help me figure out if I should stay. If I should stay, I should do so even considering the worse case scenario I suppose. I know I am very obsessive about my health, probably close to hypochondriac status, but I can keep it in relative control. There is always the chance that a relationship won't work out, and should that happen and I contracted this, I fear my mental state will be far worse than the reality of that situation.
I do feel better knowing that genital-genital hsv-1 transmission is mostly in theory. I felt this was the case all along. A few more questions might help a bit more as well, though.
1) Is it true that broken or weakened skin is primarily the site of transmission?
2) My dermatologist also said that my excellent health would offer extra immunity from contracting in the first place. Is this true?
I do feel better knowing that genital-genital hsv-1 transmission is mostly in theory. I felt this was the case all along. A few more questions might help a bit more as well, though.
1) Is it true that broken or weakened skin is primarily the site of transmission?
2) My dermatologist also said that my excellent health would offer extra immunity from contracting in the first place. Is this true?
MEDICAL PROFESSIONAL
Interesting story. There are atypical features of your gf's story, but it's all possible. The responses below assume all the information is accurate, including the fact that her genital area (but not strictly genital) HSV infection indeed is due to HSV-1 and not HSV-2. The infrequency of her symptomatic recurrences favor HSV-1.
Second, in response to your second paragraph: Genital herpes simply is not all that important. If the relationship is important to you, fear of catching HSV should not even enter into the picture. Most cases are asymptoamtic or cause mild symptoms at worst; there rarely are serious long-term health problems; and once you're in a committed relationship, the fear of transmitting to someone else no longer is a problem. It is a gross overreacttion to be worried about "risking your sanity" over all this.
1) I cannot assess your risk; there isn't enough information. There is at least a 50:50 chance you already have HSV-1. If so, you are immune and cannot catch it again, anywhere on your body. You could have a blood test to find out whether you already have it. But even if you are susceptible, the chance of transmission probably is very low, especially if you avoid sex when she is having a symptomatic outbreak.
2) There are few data on asymptomatic shedding of genital HSV-1; almost all the research is with HSV-2. Most experts (including me) believe asymptomatic shedding of genital HSV-1 is uncommon, and I have never seen (or heard of) a case of genital-to-genital HSV-1 transmission. It probably can occur, but apparently is rare.
3) I don't see what is so abnormal about your gf's genital area HSV-1 infection, except the route by which she caught it.
Bottom line: I think you can ignore all this business. It doesn't sound like an important issue, except in your mind.
Best wishes-- HHH, MD
Second, in response to your second paragraph: Genital herpes simply is not all that important. If the relationship is important to you, fear of catching HSV should not even enter into the picture. Most cases are asymptoamtic or cause mild symptoms at worst; there rarely are serious long-term health problems; and once you're in a committed relationship, the fear of transmitting to someone else no longer is a problem. It is a gross overreacttion to be worried about "risking your sanity" over all this.
1) I cannot assess your risk; there isn't enough information. There is at least a 50:50 chance you already have HSV-1. If so, you are immune and cannot catch it again, anywhere on your body. You could have a blood test to find out whether you already have it. But even if you are susceptible, the chance of transmission probably is very low, especially if you avoid sex when she is having a symptomatic outbreak.
2) There are few data on asymptomatic shedding of genital HSV-1; almost all the research is with HSV-2. Most experts (including me) believe asymptomatic shedding of genital HSV-1 is uncommon, and I have never seen (or heard of) a case of genital-to-genital HSV-1 transmission. It probably can occur, but apparently is rare.
3) I don't see what is so abnormal about your gf's genital area HSV-1 infection, except the route by which she caught it.
Bottom line: I think you can ignore all this business. It doesn't sound like an important issue, except in your mind.
Best wishes-- 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.
