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Possible HSV-1 exposure
Hi there-
I started casually dating a woman a few weeks ago. On June 16th, we had a long makeout session, and the following week, 22nd-23rd we had sex both nights (unprotected oral,protected vaginal and anal). I found out yesterday that she had what she said was her first cold sore appear the Monday after we had sex. She said that she thought that I gave it to her, because never had one before. I said that I didn't think so, because I have never had cold sores in my teens or adult life (i vaguely remember having one when i was 6, but i cant be sure how accurate that is). She said that she wasnt intimate with anyone else in the time frame, but others that I have kissed in that time frame haven't developed symptoms.
Now, I am really worried because she went down on me 2 days before a cold sore appeared. This is the 11th day since sex and i havent experienced any symptoms yet either on the mouth or on the genitals.
Also, I saw her last night and she said that she was using prescription antiviral cream since the breakout (which would have been 8 days). She kissed me on the neck and cheek, and on the lips once. I washed my lips with soap and water immediately, but didnt wash the other areas.
How much risk am I at? When can i stop worrying? :)
I started casually dating a woman a few weeks ago. On June 16th, we had a long makeout session, and the following week, 22nd-23rd we had sex both nights (unprotected oral,protected vaginal and anal). I found out yesterday that she had what she said was her first cold sore appear the Monday after we had sex. She said that she thought that I gave it to her, because never had one before. I said that I didn't think so, because I have never had cold sores in my teens or adult life (i vaguely remember having one when i was 6, but i cant be sure how accurate that is). She said that she wasnt intimate with anyone else in the time frame, but others that I have kissed in that time frame haven't developed symptoms.
Now, I am really worried because she went down on me 2 days before a cold sore appeared. This is the 11th day since sex and i havent experienced any symptoms yet either on the mouth or on the genitals.
Also, I saw her last night and she said that she was using prescription antiviral cream since the breakout (which would have been 8 days). She kissed me on the neck and cheek, and on the lips once. I washed my lips with soap and water immediately, but didnt wash the other areas.
How much risk am I at? When can i stop worrying? :)
Thanks, Dr. Handsfield. I apologize if I was being impatient and I hope that you had a nice holiday break. I am glad that you provide this service to the community.
MEDICAL PROFESSIONAL
Sorry, I have been on holiday for a week without online access. FYI, MedHelp does not guarantee any follow-up comment or discussion, and indeed many (most?) professionally moderated forums offer no follow-up at all. Dr. Hook and I do so, but at the same time we are not online 24/7.
Your blood test shows you definitely are infected with HSV-1. Although the blood test says nothing about anatomic location of your infection, the large majority of HSV-1 infections are oral, not genital. You undoubtedly were infected before the sexual exposure 2 weeks earlier, which is too soon for a positive blood test. And the level of the numerical result says nothing about how long the infection has been present.
This makes it possible that you were the source of your partner's oral herpes. If so, it probably occurred by kissing, and not by her oral contact with your penis. However, for the reasons described above, it is equally likely that her oral herpes also is a longstanding infection and not a new one. In other words, I suspect you both had had longstanding HSV-1 infections. But that's something you're going to have to sort out with her and her doctor(s).
You are correct that your low level HSV-2 result, while technically positive, probably is false. It is unlikely you have HSV-2.
Your blood test shows you definitely are infected with HSV-1. Although the blood test says nothing about anatomic location of your infection, the large majority of HSV-1 infections are oral, not genital. You undoubtedly were infected before the sexual exposure 2 weeks earlier, which is too soon for a positive blood test. And the level of the numerical result says nothing about how long the infection has been present.
This makes it possible that you were the source of your partner's oral herpes. If so, it probably occurred by kissing, and not by her oral contact with your penis. However, for the reasons described above, it is equally likely that her oral herpes also is a longstanding infection and not a new one. In other words, I suspect you both had had longstanding HSV-1 infections. But that's something you're going to have to sort out with her and her doctor(s).
You are correct that your low level HSV-2 result, while technically positive, probably is false. It is unlikely you have HSV-2.
It has been two days since i've posted this follow-up question. If I am out of follow-ups, that is fine, but please let me know.
Also, I took this test on Thursday evening, which would have been almost two weeks after the exposure (she had the cold sore on monday- and we hooked up that fri and sat), and two days after she kissed me with sore.
Hi Dr. Handsfield-- thank you for your help so far. I got Igg blood tests back, and my results were:
IGG HSV-1 >5.0 Positive
IGG HSV-2> 1.37 Positive
I've read that the HSV-2 at that level is somewhat ambiguous, band clearly i am positive for HSV1... With such a high number, would that indicate a more recent infection (within the past 2 weeks?) I guess my question is how long does it take for results to become pos on these tests, and does the number indicate recency?
IGG HSV-1 >5.0 Positive
IGG HSV-2> 1.37 Positive
I've read that the HSV-2 at that level is somewhat ambiguous, band clearly i am positive for HSV1... With such a high number, would that indicate a more recent infection (within the past 2 weeks?) I guess my question is how long does it take for results to become pos on these tests, and does the number indicate recency?
MEDICAL PROFESSIONAL
We probably can assume your partner's diagnosis is correct. However, I'll be her dad isn't much of a herpes expert. If he were, he would know that the antiviral anti-herpes cream is very weak treatment; effective therapy requires drug by mouth. There are no data on whether the cream would protect against transmission, but probably not much. In any case, what I said above about a single lesion probably being a recurrent infection remains true -- so it remains unlikely you infected her.
If your dim recollection is of sores on the lips or outside the mouth, herpes is a good bet -- in which case you are immune. You could have a blood test for HSV-1 antibody.
All HSV infections start out exactly where they are inocluated, and generally remain there or nearby. A neck exposure would not result in lip or facial lesions.
Most important, you can indeed be very confident you were not infected if there were no symptoms within 3 weeks; in fact, symptoms usually start within 3-5 days, so you're pretty much out of the woods by a week.
If your dim recollection is of sores on the lips or outside the mouth, herpes is a good bet -- in which case you are immune. You could have a blood test for HSV-1 antibody.
All HSV infections start out exactly where they are inocluated, and generally remain there or nearby. A neck exposure would not result in lip or facial lesions.
Most important, you can indeed be very confident you were not infected if there were no symptoms within 3 weeks; in fact, symptoms usually start within 3-5 days, so you're pretty much out of the woods by a week.
Thank you for answering my question.
One clarification-- i made a mistake -it was July 16th that these events began to unfold. So, are you saying that if i haven't had symptoms till Aug 13th, I'm in the clear? Can i ease up the worry by the 6th (2 weeks?) Is there anything that I could do to ease my worry, or do i just have to play the waiting game? would taking an HSV blood test at this point confirm that i had it before or would it indicate a current infection?
To respond to your questions..
Her father is a doctor and he diagnosed it as oral herpes and gave her a prescription.
I cannot be sure what my symptoms were-- like i said, i was probably about 5 or 6 but i kind of remember having one, but i cant confirm.
does using a prescription antiviral cream reduce chance of infection if taken for 8 days as Rx'ed? and if i get kissed on my neck or cheek, would that be where the sore appeared or would it travel down to the lips?
thanks!
One clarification-- i made a mistake -it was July 16th that these events began to unfold. So, are you saying that if i haven't had symptoms till Aug 13th, I'm in the clear? Can i ease up the worry by the 6th (2 weeks?) Is there anything that I could do to ease my worry, or do i just have to play the waiting game? would taking an HSV blood test at this point confirm that i had it before or would it indicate a current infection?
To respond to your questions..
Her father is a doctor and he diagnosed it as oral herpes and gave her a prescription.
I cannot be sure what my symptoms were-- like i said, i was probably about 5 or 6 but i kind of remember having one, but i cant confirm.
does using a prescription antiviral cream reduce chance of infection if taken for 8 days as Rx'ed? and if i get kissed on my neck or cheek, would that be where the sore appeared or would it travel down to the lips?
thanks!
MEDICAL PROFESSIONAL
Welcome to the forum. There are 3 intertwined issues/questions here: Does your partner have oral herpes? If so, did she catch it from you? And if so, were you at risk of catching it from her? Let's take them one at a time.
Self-diagnosis of oral herpes isn't highly reliable. It would be helpful to know more about her cold sores (as well as the symptoms you had when you had cold sores in childhood). The most common mistake is for people to believe canker sores (inside the mouth) are the same thing as cold sores (on the lips or face). What did your partner have and what were your symptoms like in childhood? Bottom line: without more information, I cannot judge whether your partner has oral herpes or not. But for the other questions, I will assume she does.
Initial oral herpes usually causes multiple painful sores in the mouth, and sometimes on the lips as well, and sore throat which usually is severe. Often there is fever. A single cold sore rarely is due to a new HSV infection, but actually is a recurrent outbreak -- even if the infection previously was asymptomatic with no known outbreaks. So if your partner has oral herpes, I doubt she caught it from you during the sexual events described.
If your partner's possible outbreak had begun before the sexual events together, transmission to your mouth by kissing, or to your penis by oral sex, was a significant risk. However, half of all adults have had HSV-1, and if your childhood symptoms indeed were oral herpes, than you can assume you are already infected. If so, you are highly resistant -- perhaps completely immune -- to a new HSV-1 infection, anywhere on the body. Assuming you didn't have symptoms (oral or genital sores, sore throat) within 3 weeks after the event -- i.e. by July 7 or thereabouts -- you can be quite certain you were not infected.
My final comment is that if your partner indeed believes she has oral herpes, she has no business kissing you (or anyone else) when having an outbreak. Although oral herpes usually is a minor health issue, there is no point in putting people at risk unnecessarily.
I hope this helps. I may be able to provide more information if you would like to fill in some of the missing details.
Regards-- HHH, MD
Self-diagnosis of oral herpes isn't highly reliable. It would be helpful to know more about her cold sores (as well as the symptoms you had when you had cold sores in childhood). The most common mistake is for people to believe canker sores (inside the mouth) are the same thing as cold sores (on the lips or face). What did your partner have and what were your symptoms like in childhood? Bottom line: without more information, I cannot judge whether your partner has oral herpes or not. But for the other questions, I will assume she does.
Initial oral herpes usually causes multiple painful sores in the mouth, and sometimes on the lips as well, and sore throat which usually is severe. Often there is fever. A single cold sore rarely is due to a new HSV infection, but actually is a recurrent outbreak -- even if the infection previously was asymptomatic with no known outbreaks. So if your partner has oral herpes, I doubt she caught it from you during the sexual events described.
If your partner's possible outbreak had begun before the sexual events together, transmission to your mouth by kissing, or to your penis by oral sex, was a significant risk. However, half of all adults have had HSV-1, and if your childhood symptoms indeed were oral herpes, than you can assume you are already infected. If so, you are highly resistant -- perhaps completely immune -- to a new HSV-1 infection, anywhere on the body. Assuming you didn't have symptoms (oral or genital sores, sore throat) within 3 weeks after the event -- i.e. by July 7 or thereabouts -- you can be quite certain you were not infected.
My final comment is that if your partner indeed believes she has oral herpes, she has no business kissing you (or anyone else) when having an outbreak. Although oral herpes usually is a minor health issue, there is no point in putting people at risk unnecessarily.
I hope this helps. I may be able to provide more information if you would like to fill in some of the missing details.
Regards-- 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.
