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Incubation Period for HSV 1
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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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Incubation Period for HSV 1

My boyfriend and I were arguing over the incubation period for contracting HPV 1.  The doctors say it's 2-20 days generally.
He's saying he did some sort of research and that you could have it up to 6 months prior to having a break out.

I've done some online research and not come up with ANYTHING that says 6 months - everything is saying 2 days to a couple of weeks, which is what i originally thought.

Can you please help!?
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I'll assume you in fact mean HSV-1 (from the title of your question) and not HPV-1 (from the first line).  I'll also assume that since this is an STD forum, you are mostly interested in genital herpes due to HSV-1.  Probably you understand that the large majority of HSV-1 infections, the cause of cold sores (also called fever blisters) involve the mouth and are not sexually transmitted.

There are not very good data on this; genital HSV-2 has been more extensively studied than HSV-1.  However, the large majority of infections due to either virus generally are believed to have incubation periods -- that is, the time from exposure to onset of symptoms -- of 3-10 days, sometimes up to 3 weeks, but never longer than that.  So at one level, you are correct and your boyfriend is wrong.

The confusion arises because initial infection sometimes are unrecognized.  Either they cause no symptoms at all, or the symptoms are mild or are mistaken for something else.  However, HSV infections tend to cause recurrent outbreaks.  Therefore, it is common for people to have what seems to be the first infection, several months (even several years) after the infection actually was acquired.  That can make it seem like an incubation period of months or years.  But what seemed to be the first outbreak actually was a recurrence.

I hope that helps.  Best wishes--  HHH, MD
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Avatar_n_tn
Thank you for your help on this.  I believe my current boyfriend actually gave this to me.  2-3 weeks after sleeping together I was having serious problems and knew something was wrong.
I went to the clinic and they diagnosed me with HSV-1.  The dr said due to the time periods and he'd been the only one I'd slept with in two months - that it was him, and would not have been from my previous partner I was with for 5 years.
My boyfriend argued that I could have had it before, but I was soooo sick when I had the initial outbreak with flu like symptoms, vomitting, my glands were all swollen that the dr said that it was definately the initial outbreak, which is the worst I would ever get.
I just wanted to confirm that there wasn't any legitimacy to what my boyfriend was saying from another source because he made me worry about it.  However, I'd had a PAP testing and the do test for certain STD's and never had a single instance of any issues with yeast (which is what I thought the HSV-1 was at the very beginning of the symptoms) or any other issues in years.

I really appreciate your advice...
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239123_tn?1267651214
Recurrent herpes outbreaks almost never cause multiple genital sores, fever, flu symptoms, etc.  Assuming those symptoms indeed were due to herpes, for sure you were having your first infection.  It is almost certain you were exposed to the virus 3-10 days (no more than 3 weeks) before your symptoms started.  If your boyfriend was the only person you had sex with during that time, for sure you caught it from him.

You don't actually say where your infection is.  I assume you are indeed speaking of genital herpes and not oral; and that the virus type (HSV-1 and not HSV-2) has been confirmed by laboratory testing.  Either virus type can infect the genital area.  However, if indeed you have an initial genital HSV-1 infection, almost certainly you caught it through oral sex.  Does he have a history of cold sores?  Did he by chance have one in the week or so before your symptoms started?  Even if not, it really doesn't matter; he could have oral HSV-1 with no symptoms.

Your boyfriend should have a blood test, which can tell for sure whether he is infected with HSV-1 (or HSV-2, for that matter).  He should expect a positive result for HSV-1.
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Avatar_n_tn
Yes, I'm sorry, I did get actual labratory testing through a local STI/STD clinic.  The results came back positive for herpes HSV-1.  It is not HSV-2 - I was negative for that.  I haven't had another break out since either, but as soon as my boyfriend questioned my integrity on what the doctor had told me at the clinic about the time I contracted it, I was very concerned and wanted to get a 2nd opinon.

He was absolutely the only one I slept with in that time and no one for 2 months before that because the relationship with my 5-yr boyfriend wasn't going well - and has obviously ended.  

My boyfriend claims he never had a single outbreak or had no idea that he had this - which I do believe him because I know that you can have it and not know if you do not have symptoms.  He has never had a cold sore.  I'm wondering if one of his previous girlfriends gave it to him through unprotected sex, which I'm going to say is more than likely!

The flu like symptoms were swollen glands in my neck and around the groin area - and very painful!!  I had really bad headaches and was really tired as well.  It wasn' the flu because as soon as I started taking the prescribed Valtex, these symptoms went away.  I also had redness in the area and about 3 days later little blisters appeared and that's why I got it checked.... I knew something was seriously wrong and I was right!!

So no matter how it got contracted, he would have HSV-1 either way and it would not have been something that I was carrying all along?
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239123_tn?1267651214
Defininitely you have not had this all along.  And I agree your boyfriend probably is telling the truth.

But I'm still not completely clear on the basis for the HSV-1 diagnosis. If that was from a swab of a lesion, i.e. HSV-1 was identified by examining the virus itself, then for sure that is what you have.  If you had a blood test that was positive for HSV-1, then it is more likely your genital infection is due to HSV-2.  It takes a few weeks for a blood test to become positive; it would be too soon to be positive in the blood for HSV-1 within a few days of onset of symptoms.

So is your diagnosis based on blood test or viral test from a genital lesion?
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Avatar_n_tn
The testings came from the swabs of lesions, there was no blood testing done.  They said if the test results were unclear when they came back they would do blood testing or urine testing.
However, the swab took a bit to come back and when it did they had me come back to their office to notify me that it was HSV-1 herpes that I have.
They said I did not show any signs or show that I had HSV-2.
I had multiple lesions - probalby at least 5 or 6 when it happened.
I thought I may have been having a 2nd break out 3 weeks later, but I think it was a false alarm.  It's been 6 months almost since it's happened and no other symptoms or break outs have occured, nor have any ever apparently happened with my boyfriend who I contracted this from.  
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239123_tn?1267651214
OK.  All I said in the previous replies holds up.  Most likely your boyfriend as an undiagnosed oral HSV-1 infection.  Conceivably it could be genital, but genital to genital HSV-1 transmission is rare; most cases come from oral-genital exposure.  His HSV-1 blood test (if he agrees to it) will be positive.  In discussing this with him, it is important to stay away from the blame game.  Since he didn't know he was infected and probably had no symptoms, this is nobody's fault; and most likely his infection didn't come from another sex partner, so there are no implications for infidelity.

Presumably you are on antiviral therapy.  HSV-1 often requires higher doses of acyclovir or valacyclovir than HSV-2.  If your symptoms haven't largely improved within 2-3 days of treatment, talk to your doctor to make sure you're on a large dose.

Good luck-- HHH, MD
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