Transmission of HSV-1 virus

I was diagnosed with HSV-1 and HSV-2 one year ago. I am living in Singapore, a place where Herpes is something rare.

I do not have any sores since i aquired Herpes. Because my symtoms (symptoms) are mild, i do not know when i am having an outbreak or having asymtomic shredding of HSV-1 virus. If my face feel tiggering feelings, does it mean that i am shredding the virus?

I knew of 1 girl recently, i do not wish to have any sexual encounter with her. But i am asking whether i can kiss her mouth to mouth if i do experience any sores on my mouth. Will i be having asymtomic shredding of HSV-1 virus and spread it to her? Will i pass it to her if i kiss only her facial area?

I sometime encounter tingling sensation on my facial area, can we have any facial contacts?

I really like this girl, but i am troubled by spreading any virus to her. I am recently under supressive therapy Valtrex for 1 week, but i understand the duration of therapy have to be longer to have any effect.

How frequent is asymotomic shredding of HSV-1 virus? If i continue valtrex, then i did not have any sores, but if there is asymotomic shredding of HSV-1 virus, is there any chances of spreading HSV-1 to her?

Please advice as i really wish her to be my girlfriend

[H. Hunter Handsfield, M.D.]

I'm not sure where you heard that genital herpes is uncommon in Singapore.  In fact, it is a common STD in the Singapore's main Division of STD Control (DSC) Clinic (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15098634&query_hl=1&itool=pubmed_docsum)

Don't worry very much about transmitting HSV-1.  It is not likely to be sexually transmitted and your facial tingling probably is meaningless, unless such tingling precedes development of an overt oral herpes lesion (cold sore, fever blister).  Tingling alone probably does not usually indicate an HSV outbreak.  In general, asymptomatic oral shedding of HSV-1 is less frequent than genital shedding of HSV-2; and if your HSV-1 infection was acquired in childhood, which is likely, you may have no recurrent shedding at all.  Further, the odds are better than 50:50 that your girlfriend is already infected with HSV-1; if so, she is immune to catching it again.  And if she does get infected from you, she probably will never know it and probably will not have frequently recurrent disease, either orally or genitally.

The greater risk to your partner is for HSV-2.  About 1/3 of people with chronic HSV-2 infection have typical genital symptoms with recurrent outbreaks (although even some typical cases are unrecognized); 1/3 have no symptoms at all and 1/3 have subtle symptoms.  But these subtle symptoms all are genital:  an itch, a minor sore, an irritated feeling, and sometimes a localized neuropathic prodrome, with tingling, numbness, or pain in the area where an outbreak is about to occur.

My advice is to frankly discuss your situation with your girlfriend and arrange for her to have type-specific HSV testing.  The result will tell both of you whether she is susceptible to either or both viruses and will help to determine what precautions to take.  For example, if she is HSV-2-negative, you not only need to be on the lookout for subtle symptoms of outbreaks, but can consider routine use of condoms and/or use of suppressive antiviral therapy to help prevent transmission.

OOPS:  After all that I see your closing comment that you are already taking valacyclovir (Valtrex).  If you continue suppressive therapy indefinitely, you will reduce (but not completely eliminate) the chance of transmitting either HSV-1 or HSV-2.  My advice still goes about having her tested for both viruses before you enter a sexual relationship.

Finally:  The Singapore DSC is excellent.  If you are not under that clinic's care, you should attend for at least an initial consultation and follow their advice.

Good luck--  HHH, MD

[edmund45]

Sorry, i wished to changed the questions post as i do not have any sores on my mouth. Sorry for the trouble


I knew of 1 girl recently, i do not wish to have any sexual encounter with her. But i am asking whether i can kiss her mouth to mouth if i do not experience any sores on my mouth. Will i be having asymtomic shredding of HSV-1 virus and spread it to her? Will i pass it to her if i kiss only her facial area?

[H. Hunter Handsfield, M.D.]

Please do not post 2 threads on the same topic.  I deleted your second thread.  Your additional questions are answered here.

"I was diagnosed with HSV-1 and HSV-2 one year ago and i lived in Singapore, a place where Herpes is rare. My reading from blood test is as follows: herpes 1 IgG >3.5
herpes ll IgG 1.52"

"Q1) This reading means that i have both HSV-1 and HSV-2?"

YOU CLEARLY HAVE HSV-1.  YOU MAY OR MAY NOT HAVE HSV-2; 1.52 IS AN EQUIVOCAL RESULT.  REQUEST REPEAT TESTING; IF STILL EQUIVOCAL (1.0-3.0), ASK YOUR PROVIDER TO SEND A SPECIMEN FOR CONFIRMATORY TESTING BY WESTERN BLOT.

"Q2) I sometimes experience very itching feeling on my hands, is that cause by herpes virus? If yes, any possible way it will be transmit to other people?"

NO, THIS IS NOT A HERPES SYMPTOM AND IS VERY UNLIKELY TO INDICATE A RISK OF TRANSMISSION.

"Q3) My seldoms are mild and i do not experience any sore since i get herpes. But i experience tingling sensation on my facial area. Does it mean that i am having an outbreak?"

NO; SEE MY ORIGINAL RESPONSE.  YOUR HSV-1 INFECTION PROBABLY IS MANY YEARS OLD, UNLESS YOU HAD RECENT NEW SYMPTOMS EITHER GENITALLY OR ORALLY.

"Q4) i recently like a girl, i do not wish to have any sexual contact with her, can i kiss her mouth to mouth if i do not have any sores, and i have been on suppressive therapy Valtrx for 1 week but i cannot confirm i have any asytomic shredding since i do not know when i am having outbreak, whats the chances i will pass HSV-1 virus to her."

SEE MY ORIGINAL RESPONSE.  TRANSMISSION RISK BY KISSING IS EXTREMELY LOW, ESPECIALLY IF YOU HAVE CHRONIC AND NOT NEW INFECTION; AND ESPECIALLY IF YOU CONTINUE TAKING VALACYLCOVIR.

"Q5) Lets say that i kiss her on her face and forehead, and i do not have any sores, being on Valtrex for 1 week, but do not know whether i have any asytomic shredding, is it 100 % safe for her?"

THIS IS A VARIATION ON THE SAME QUESTION AND THE ANSWER IS THE SAME.

"Q6) Sometimes i have break in my skin due to the hot weather, can i kiss her on her face and forehead, lets say the scenario is the same as Q5) , is it 100 % safe for her?"

SKIN BREAKS NOT DUE TO HERPES CARRY ZERO RISK OF HERPES TRANSMISSION.

Most of your qeustions imply you are much more concerned about this than necessary.  If you still are in Singapore, visit the DSC and follow their advice; if elsewhere, seek the advice of a provider who is familiar with STDs.

HHH, MD