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HSV1 transmission to genitals
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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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HSV1 transmission to genitals

Hey There,

I have a question about the possibility of transferring HSV1 to someones genitals.  I had my first HSV1 cold sore back in college right as I began to date my current wife. Not knowing much about it we were not particularly careful and not long after she developed cold sores as well.  That was 12 years ago, and we have gotten to a place where our outbreaks are pretty well controlled with Famvir.   About 2 weeks ago I had oral sex with my wife, and 3 or 4 days before that I had felt an outbreak coming on and took some Famvir.  The outbreak didn't develop to much of anything, and there were just some small non-visible scabs on my lip.  In fact I had forgotten about the whole thing since there was not much of an outbreak.  Regardless, she is now having pain/discomfort in her genital area, and is scheduled to see the doctor.   I did find this on one of your message boards:

"by H. Hunter Handsfield, M.D., Mar 03, 2005 12:00AM

During the initial infection with either HSV-1 or HSV-2, the infection can be transmitted to any other body part (autoinoculation).  It usually shows up as herpes of the eye or a finger during the first outbreak of genital or oralherpes.  But once the infection has been established for a few weeks, autoinoculation occurs so rarely that nobody need be concerned about it; the immune system protects against transmission to other body sites.

If two people are infected with HSV, either HSV-1 or -2, they never transmit it back and forth.  The immune system protects against a new infectionwith the same virus type.  People don't "ping-pong" herpes infections between one another."

My question is in regards to the second paragraph.  Does this mean that since we both had the same (I'm assuming) HSV1 virus that the infection it couldn't be passed between the two of us again?  

There are other possible explanations for my wife's discomfort (yeast infection, new heavily perfumed laundry detergent), but we are pretty concerned about the HSV1.



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There are few absolute truths in biology and medicine; the human body is too variable -- I have said many times that people who already have HSV of either type are immune, or at least highly resistant, to catching the same virus type again, anywhere on the body.  Therefore, if your wife indeed has had an oral HSV-1 infection, it is unlikely that her current genital symptoms are due to HSV-1.

However, I cannot say it is impossible, and my use of "never" in the statement you quote might be too strong. In defense, the statement actually is meant to refer to repeated back and forth thransmission, which definitely doesn't occur.  But one such transmission might be possible.)  The timing of your wife's symptoms with the oral sex exposure is consistent with herpes, but aytpical; most new infections cause symptoms in 3-10 days, although it can be longer.  But from your description, you likely were no longer infectious at the time of the oral sex event, so there might have been no exposure at all.

Another consideration is whether your wife really does have preexisting HSV-1 infection.  You don't describe enough detail about her oral symptoms to know with certainty whether she acquired your oral HSV-1 before now.  If not, she could be fully susceptible to her first HSV-1 infection.

All things considered, it is unlikely that herpes is the cause of your wife's symptoms, but it might be possible.  She should see her health care provider immediately -- not because it's any kind of emergency, but because diagnosis of new herpes is much more reliable if the lesions can be examined and tested early, preferably within 2-3 days of onset.  She should make sure her provider is aware of the possible HSV exposure.

Finally, if indeed your wife has new genital herpes due to HSV-1, be aware that most genital HSV-1 infections have only 1-2 recurrent outbreaks in the next 1-2 years, then no more; and the recurrences tend to be mild and brief.  So even if it's herpes, this isn't something that should cause great concern.

I hope this helps.  Best wishes--- HHH, MD
4 Comments
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Avatar_n_tn
Thanks for the response, and sorry I wasn't more clear on her oral symptoms.  She did start to get cold sores not long after an episode where we kissed and I still had a cold sore, and has had them ever since off and on consistent with the triggers that can bring on HSV1 outbreaks.  I believe that she has also been diagnosed, and they respond to Famvir.  Anyway, thanks for the advice and here's keeping our fingers crossed.  
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239123_tn?1267651214
While she waits to see her doctor, the two of you should be able to get pretty good clues.  If her genital irritation is diffuse, i.e. redness/irritation, but without blisters or open sores, then herpes is unlikely.
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Avatar_n_tn
Just to follow up...Went to the doctor this AM and there is an infection on the cervix, and no evidence of blisters or open sores; so looks not to be HSV1.  Thanks for the help.
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