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HSV 1 oral to genital (prevention) need help ASAP
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HSV 1 oral to genital (prevention) need help ASAP

I am REALLY worrying after I developed a cold sore shortly after having oral & vaginal sex with my male partner (i am fem.). I started getting cold sores as a child (9, i'm now 29) & normally have 1 episode a year. Because of this, i stopped taking valtrax daily as suppressive therapy, & now only use it to try & prevent an outbreak in the month of november (when it usually occurs).

For some reason, I now have a cold sore developing & noticed symptoms (some tingling, small bumps) a mere hour or so after we were intimate. My partner of 5 months is 31 & I understand that lots ppl already have HSV 1 by this age AND if he's ever had a cold sore then he can not get HSV 1 from me (orally or genitally correct?).

The problem is I have no idea whether or not he has HSV 1 (as so many ppl never have recurrences  essentially forget about it)  MORE IMPORTANTLY if there is anything i can do to reduce his risk of transmission, at this point, given the chance that he is HSV1 neg.

1) I've read that uninfected partners taking valtrax reduces their rate of infection. Should i give him some of my valtrax pills, as it's only been 6 or so hours since we were intimate? Is there any chance that this would do ANY good? if so, how much?

2) While intimate, we kissed on the mouth, engaged in oral sex & then vaginal inter. I understand that HSV 1 prefers its host site (mouth). Thus is there a greater chance that he would get HSV 1 orally from me than genitally (as we were kissing orally before oral sex)?

3) What do i do now? It's been less than 12 hours since we were intimate and I am worried about transmission. I didn't realize i was developing a cold sore last nt and by the time i realized it, we had already been together. What is the probability of infection, if he is HSV 1 negative? We've been sexual for 4 months and never had any health related problems.

Please answer all these questions, if possible and i GREATLY appreciate any prompt help, feedback and advise you can provide.
Tags: HSV-1
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Welcome to the forum.  These are good questions.  You are correct that this situation carries a high risk of transmission of HSV-1 to your partner, if he is susceptible -- i.e. if he hasn't previously had it (but only then).

1) There are no data on the effectiveness of anti-HSV treatment to prevent infection in exposed persons.  Animal studies are not promising.  If an animal (e.g, mouse, guinea pig) is given acyclovir BEFORE inoculation with HSV, infection is prevented.  If treatment is delayed until AFTER inoculation, even by only 1 hour, infection is not prevented.  So most likely it is too late to make a difference in your partner's risk of infection.  And a downside is that treatment at this point delay or modify symptoms, so he and you might end up being more uncertain than otherwise.

2) The lips and mouth might be more susceptible than the penis to HSV-1 (the reverse of HSV-2), so my guess is your partner is more like to catch oral than genital herpes.  But I stress "guess"; there are no data and either or both sites could be infected.

3) At this point, my advice is to sit tight and keep your fingers crossed.  In addition, your partner could have a blood test now for HSV-1.  If positive, he is already infected and your worries are over.  If negative, you can be on the lookout for symptoms and prompt treatment.  And you'll also have a baseline result in case things remain uncertain in a few weeks and another test is done.

Statistically, the odds are against transmission.  Unfortunately, you're just going to have to wait and see.  As you do, remember that genital herpes due to HSV-1 usually is no big deal, with few recurrent outbreaks and probably low risk of future sexual transmission.

Please retune with follow-up comment(s) and let me know how it all turns out.

Regards-- HHH, MD
5 Comments
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Thank you, SO MUCH for your feedback. I'm worried because i am generally pretty conscientious, health-wise and have never engaged in any type of sexual activity with ANYONE when I've had a cold sore. Problem is, i didn't realize one was forming and it was too late once i did:( Sometimes i get warning signs, and sometimes i don't.

I'm not quite sure if I understand how getting a test would help RIGHT now. If it came back positive (like tomorrow or next week). Couldn't that have theoretically been caused by our encourater or would it definitely indicate a previous cold sore in his life (or less likely, genital HSV 1). How long shall i keep my fingers crossed? I know some ppl have very mild or non existent symptoms, so would absence of obvious symptoms necessarily mean non-transmission? After how long (with no symptoms) could i be fairly certain that our encounter did not infect him (if he's currently HSV 1 negative, that is).

I would feel horribly guilty if he contracted HSV1 genitally from me, despite my non knowledge that I had a cold sore forming and the generally mild symptoms it carries. I only usually get one outbreak a year (usually)...is it wise for me to take daily suppressive therapy to protect myself and future partners? What do you know about Dynamiclear? Any sound evidence one way or the other? How often are ppl infected both orally and genitally from oral HSV1?

Finally, I don't know how to begin this conversation with him. Because cold sores are so common and I get infrequent outbreaks, i rarely tell anyone about it...aside from my last partner who also had previous oral HSV 1, so we kinda bonded over it. Not sure how to go about this....

Thanks so much!



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239123_tn?1267651214
Don't beat yourself up over bad luck in timing.  Being conscientious is good, but not foolproof.  And of course there is always some potential for transmission in the absence of an overt outbreak; lower, but still possible.  I don't know what Dynamiclear is, but the name alone suggests quackery, at least to me. If it doesn't contain one of the standard HSV drugs (acyclovir etc), I can't imagine that it works to prevent outbreaks or transmission.

It is much too soon for a positive antibody test from this exposure.  10 days is the minimum and it's usually 2+ weeks.

This isn't a counseling service, but you might get good advice on talking to your partner on the herpes community forum.  But you have to do it, with no delay.  If he was infected, symptoms could start as soon as 2-3 days after exposure.  You will agree it would be a worse experience if he gets symptoms before you have said anything.  You don't want to start the conversation with "I was meaning to call you".
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239123_tn?1267651214
I looked up Dynamiclear.  It's the amino acid lysine, which has been touted as a herpes remedy for 30-40 years.  It's not quite quackery, since there is at least a theoretical reason -- based on the biology of HSV -- that it might suppress growth of the virus.  However, it does not actually do so, and it is completely ineffective in preventing outbreaks, preventing transmission, or speeding up healing of outbreaks.  Please don't waste your money on it.
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Avatar_f_tn
Dear Doctor,


Thanks so much for you help. As it turns out, everything was fine and there was no transmission btwn my partner and me. I still worry, just because it is certainly possible that i could unknowingly transmit HSV1 from my mouth during a time of asymptomatic shedding or before i notice a cold sore. Is there anything i can do (apart from using condoms during oral sex which honestly i'm not gonna do, as I don't have casual sexual partners) to decrease risk of tranmission?

Does my taking valtrex as suppression decrease my risk of shedding or passing the virus on. Isn't there now a herpes vaccine? I read one was coming and I know children receive chicken pox vaccines these days (herpes zoster, correct?).

thanks for the feedback. I'm just trying to stay conscientious and keep myself and partners safe, As it were, I've never had an std, btu don't want to pass hsv orally to anyone either.

thanks so much!
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239123_tn?1267651214
Could you transmit HSV-1 from your mouth by kissing or oral sex, during a period of asymptomatic shedding?  Sure.  The same is true for everybody else with oral herpes, i.e. half the US population.  And no, there isn't much you can do to be 100% certain it will never happen -- again, just like half of everybody you know.  Taking Valtrex probably reduces the risk, but this hasn't been studied for oral HSV-1, so we don't really know.  Personally, if I were in your situation, I would not take Valtrex and I wouldn't worry about this in the slightest.  With or without anti-HSV treatment, the transmission risk (in the absence of a symptomatic herpes outbreak) is very, very low, so don't get carried away with "being conscientious".  Certainly I do not recommend condom use in situations like this for oral sex with regular partners in committed relationships.

You misunderstood something you read about a herpes vaccine.  It is true that there is an effective vaccine against varicella zoster virus, which causes chickenpox and herpes zoster (shingles).  But no effective HSV vaccine is on the horizon; maybe someday, but certainly not in the next few years.

That will have to wind up this thread.  If you have further questions or want to discuss HSV prevention with other affected persons, consider MedHelp's herpes community forum. In the meantime, don't overreact to a normal human condition.  Good luck.
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