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STDs (Expert Forum)
HSV1 Exposure Concerns...Dr. Handsfield?
Answered by
University of Washington
Seattle - WA
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Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
HSV1 Exposure Concerns...Dr. Handsfield?
by nervous_in_ca, May 15, 2008 10:47AM
Me: 30 year old straight white male...educated, healthy, dating a 20 year old girl, have been having unprotected sex with her.
I took the Herpes IgG HerpeSelect test, which looking at now doesn't really work unless the infection was over a month ago? Results: negative
After about 2 weeks of seeing her, I got sick, which I still am. (as of now I've been sick for 2-3 days). Three days ago I was kind of achy, and then Tuesday morning I woke up with a fever that got to about 102, and was very achy and sore all around. My neck glands are swollen...which is usually the case when I get a cold...and only the left side of my throat hurts when I swallow. I slept like hell a couple of nights, and my neck is still sore. I would think that I have the flu, but no vomiting or diarrhea and I haven't lost my appetite. I did, however, wake up again this morning completely drenched in sweat.
She took the same test and had positive results - 3.51H. She says she hasn't had a cold sore in 10+ years.
Is this current sickness I have a result of my body processing and trying to fight off HSV1?
Is there an accurate test that could detect recent exposure?
If she has no sores and hasn't for years, is there really a high degree of risk me getting HSV1 from kissing and/or having unprotected vaginal and oral sex?
This girl is cool, but she's 20 and I'm 31 and the age difference will likely end up being a problem, so I don't want to get HSV1 and be stuck with it my whole life. On the other hand it's so common and not a big deal that I would feel bad ending the relationship as a result. I mean, it might not even be her fault for having it, so I don't want to toss her to the curb like she's defective or something. However, I also don't want a lifetime of embarassing sores to have to explain and regret for the few months of great sex...unless we end up lasting.
If I haven't caught it, I'd consider not seeing her anymore.
Thank you so much for your time. :)
I took the Herpes IgG HerpeSelect test, which looking at now doesn't really work unless the infection was over a month ago? Results: negative
After about 2 weeks of seeing her, I got sick, which I still am. (as of now I've been sick for 2-3 days). Three days ago I was kind of achy, and then Tuesday morning I woke up with a fever that got to about 102, and was very achy and sore all around. My neck glands are swollen...which is usually the case when I get a cold...and only the left side of my throat hurts when I swallow. I slept like hell a couple of nights, and my neck is still sore. I would think that I have the flu, but no vomiting or diarrhea and I haven't lost my appetite. I did, however, wake up again this morning completely drenched in sweat.
She took the same test and had positive results - 3.51H. She says she hasn't had a cold sore in 10+ years.
Is this current sickness I have a result of my body processing and trying to fight off HSV1?
Is there an accurate test that could detect recent exposure?
If she has no sores and hasn't for years, is there really a high degree of risk me getting HSV1 from kissing and/or having unprotected vaginal and oral sex?
This girl is cool, but she's 20 and I'm 31 and the age difference will likely end up being a problem, so I don't want to get HSV1 and be stuck with it my whole life. On the other hand it's so common and not a big deal that I would feel bad ending the relationship as a result. I mean, it might not even be her fault for having it, so I don't want to toss her to the curb like she's defective or something. However, I also don't want a lifetime of embarassing sores to have to explain and regret for the few months of great sex...unless we end up lasting.
If I haven't caught it, I'd consider not seeing her anymore.
Thank you so much for your time. :)
Doctor's Answer
by H. Hunter Handsfield, M.D., May 15, 2008 11:04AM
, May 15, 2008 11:04AM
Initial HSV infection, whether due to HSV-1 or HSV-2, certainly can cause many of the symptoms you describe, in particular fever, muscle aches, and -- if the infection is oral -- sore throat and swollen lymph nodes in the neck. However, when HSV causes such symptoms, almost always there is other, even more obvious evidence of herpes -- i.e. blister-like lesions in and around the mouth or genitals, open sores, and the like. Further, with your partner having not had an oral herpes outbreak for more than 10 years, probably she does not frequently have the virus in or around her mouth when she has no symptoms.
To be completely certain, you could have another HSV-1 blood test at around 6 weeks after the onset of symptoms. It will be very surprising if it is positive. Your symptoms are much more suggestive of a garden variety respiratory virus or strep throat. The symptoms also are classical for infectious mononucleosis. However, although mono fits with your partner's youth (and she could have the virus without symptoms), it is uncommon in persons beyond their early 20s. Still, it is a possibility -- and certainly more likely than herpes.
You don't say whether you have seen a health care provider for your symptoms, but you definitely should do so. If you have strep throat, you will need an antibiotic; and if you have mono, you certainly want to do that.
As you already seem to know, half the population has HSV-1; and by the time people reach age 40-50, it's more like 60-70%. If you get it someday (which is likely, regardless of the current events), you'll simply join the majority. It would not be likely to have any effect on your sex life or your health in general. It's not something to lose sleep over.
I hope this helps. Best wishes-- HHH, MD
To be completely certain, you could have another HSV-1 blood test at around 6 weeks after the onset of symptoms. It will be very surprising if it is positive. Your symptoms are much more suggestive of a garden variety respiratory virus or strep throat. The symptoms also are classical for infectious mononucleosis. However, although mono fits with your partner's youth (and she could have the virus without symptoms), it is uncommon in persons beyond their early 20s. Still, it is a possibility -- and certainly more likely than herpes.
You don't say whether you have seen a health care provider for your symptoms, but you definitely should do so. If you have strep throat, you will need an antibiotic; and if you have mono, you certainly want to do that.
As you already seem to know, half the population has HSV-1; and by the time people reach age 40-50, it's more like 60-70%. If you get it someday (which is likely, regardless of the current events), you'll simply join the majority. It would not be likely to have any effect on your sex life or your health in general. It's not something to lose sleep over.
I hope this helps. Best wishes-- HHH, MD
Thanks for the response. That's pretty much what I figured. I went to Kaiser this morning and they didn't seem to think it would be worth testing me for mono. Apparently my throat hurts in the wrong spot or something. My tonsils are swollen, etc.
My nurse practitioner also made a good point...that it seems so unlikely that at my age I've never been exposed. I've been with somewhere around 30 women in my life, maybe 40. Mostly safe, but I've probably had unprotected sex with 7-10 of them...but kissing and oral with a lot of the others, that's for sure. Is there any way I could just be immune to it?
I understand that it's not worth losing sleep over, but I've just been so proud to say that I'm 100% clean with NO std'd or viruses whatsoever, so this is just very alarming and concerning for me.
Do you think that sometime in the next 20 years they'll have a cure for it? It seems like we're making such progress that it's bound to happen.
Thank you again!
I don't expect a cure for herpes in the next 20 years.
Again, thank you for your time and for answering the follow up questions.
I realize I'm probably being a baby about this, but I just fears of having to deal with cold sores for the rest of my life and being one of the people that are affected badly, or something.
Does the result of her test result - 3.51H, whatever that means - give any indication of how active or dormant the virus is in her?
I'm curious why you said that you would be surprised if I tested positive for HSV1. If she has it...regardless of how active...and we've kissed and had unprotected oral/vaginal sex, I for some reason thought that I was pretty much guaranteed to be be infected.
Again, I really appreciate your time. Wish I could repay the favor.
The numerical value of the test means nothing about how active or dormant the infection is. I would be surprised if you are positive for HSV-1 for the reasons I already stated: I doubt your symptoms are due to HSV-1 and I doubt she is infectious. You and she could be lifetime partners and it's a good bet you would never catch her infection.
That's it. Take care.