Possible HSV1 Exposure

Thank you for your help.

A 47 year old woman performed unprotected oral sex on me. She later told me that she tested positive to HSV 1 and actually showed me her lab results.  The results showed that she had an HSV 1 antibody level of 1.19.  Unfortunately i don't know if it was IgG or IgM.  The doctors wrote that she has been exposed but may not have the disease since she has never had an outbreak. She seemed to conclude that this meant she couldnt pass it on. My research shows me that she s wrong. The erasons he got tested is becasue she earlier had intercourse with a man who had the virus but also had no visible outbreaks.

I believe I have had cold sores in the past when I was very young.  I do not recall having any within the past 15 years.  

It has only been 24 hours since my possible exposure. I, of course, would like to know what are the chances of receiving the HSV1 virus given these condition. I am also sure that you probably could not provide any kind of definitive answer. What are my next steps? Should get an HSV 1 test and if so how long should I wait?  Any relevant info you could provide would be greatly appreciated.

[Edward W Hook, MD]

Your risk for acquisition of HSV-1 from receipt of oral sex by the partner you mention is very close to zero and not something for you to worry about.  Here are the reasons that I say this:

1.  You state you have had cold sores in the past as a child.  If this is the case, you now have an immune response to HSV-1, the cause of most cold sores which will prevent you from getting re-infected.  
2.  Your partner did not have a lesion on her lip.  The sores associated with HSV-1 are far more infectious than asymptomatic shedding of the virus.  The vast majority of exposures to infected partners, even if they have sores or lesions, do not lead to infection.  
3.  She may not have HSV-1 at all. Her test results are in the low range of positive where false positive tests are most common.

What to do.
1.  Try your best not to worry.  Your risk is tiny.
2.  Observe. If you are going to develop lesions, they will appear in 4-10 days after exposure.  If they do not, you again, do not need to worry.  It is very unlikely that you will develop lesions.
3. As for testing, we typically do not recommend testing following low risk exposures such as yours.  The only reason for you to test at his time is to find out if indeed you have already had SHV-1.  If your antibody test is positive, you have nothing to worry about.  

Hope these comments help.  EWH