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HSV-1 & Anaphylaxis
Hi. I just tested positive for genital HSV-1. I am unaware of any previous outbreak. The outbreak either occurred a few days after (I think) or a few days prior to an anaphylactic reaction to food. I'm not sure which as I definitely had some irritation down there which I chalked up to a tremendous amount of exercise (I sweat a lot and also spent several hours one day cycling) and frequent sex. Something definitely changed 3-4 days after the anaphylaxis. My doctor believes this was a primary infection based on the severity. I was very uncomfortable and did and still do have swollen lymph nodes. My first question is do you believe I may have been infected several weeks, months or years prior to this and the anaphylaxis caused this to appear as a primary outbreak? My second question is that this is the only person I have been with since the beginning of September. I am assuming I contracted it via oral sex from him within the last few weeks. If he already has HSV1 orally and has not shown any symptoms, is it possible for me to reinfect him with genital HSV1? I just want to make sure I give him the most accurate information. Also, I'm assuming any additional allergy issues could very well trigger an outbreak. Is that correct? Thank you.
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239123 tn?1267651214
Welcome to the forum. Thanks for your question.

First, sorry to hear of your infection.  I hope you're doing OK.  Presumably you have been treated with one of the anti-herpes drugs (valacyclovir, acyclovir, famciclovir) (pills, not ointment).  If so, your symptoms should clear up completely in the next several days.

With lots of genital pain and inflamed lymph nodes in the groin, I agree with your doctor:  probably this was a primary infection.  Genital HSV-1 is almost always acquired by receiving oral sex from a partner with oral herpes -- so that aspect of your story also is typical.  Usually symptoms of primary herpes start 3-5 days after exposure, but sometimes up to 2-3 weeks.  Most likely you had an oral sex exposure during that time, right?

Could this actually be a recurrent outbreak, with greater severity due to the anaphylactic event?  I have never come across such a thing, but I suppose this is possible, due to transient immune system suppression following the anaphylaxis.  Other immune suppressing events sometimes do this.  For example, women with recurrent genital herpes who become pregnant sometimes have a severe outbreak that looks for all the world like a primary infection.

One way to sort this out would be to have an HSV-1 blood test ASAP; and if the result is negative, another one in a few weeks.  Also, your partner could be tested for HSV-1.  If this is a true primary infection, your initial test may be negative, becoming positive later; and your partner's test should be positive.

Finally, you should be aware of the important differences between genital HSV-1 and HSV-2.  Nobody wants genital herpes, but if it happens, HSV-1 is definitely preferred!  The frequency of recurrent outbreaks and the potential for transmission to future partners are much lower than for HSV-2. For more information, see the thread linked below.

I hope this has helped. Best wishes--  HHH, MD
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Thank you so much. Yes, there was an oral event so it's definitely likely. And I am on Valtrex and feeling better. Everything appears to be shrinking. I haven't had any open sores as I've read is very typical, so I was hopeful my test would come back negative. I thought this was the result of a really bad yeast infection triggered by the allergy attack. I get an infection after every one. And one thing I didn't see you address: Is it possible for me to reinfect him? Can he get it genitally now because that's where mine is or is it likely he won't because he already has oral HSV-1 (assuming again)? And since he already has it, performing oral again (him to me) would not be an issue because we are both infected in the same area, right?  Thanks again.
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239123 tn?1267651214
You've not it exactly right.  People usually are immune (or at least highly resistant) to new infections with the HSV type they already have, anywhere on the body -- and probably especially resistant to the strain they already have.  Therefore, couples do not "ping pong" their HSV infections back and forth.

Thanks for the thanks.  I'm glad to have helped.
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239123 tn?1267651214
University of Washington
Seattle, WA
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