HSV-1 Diagnosis

[jeff742]

Around 6 weeks ago I had got a lap dance where she used saliva as lubricant for a hand job.  During the past 6 weeks I have had no symptoms and due to my nature I did daily inspections.  I was still nervous so I went and got a blood test and the results came back at 1.98 or positive for HSV1.  I know that this does not tell me if I have an oral or genital infection. So now for the questions:

1) Based on the event 6 weeks ago is it likely that I have genital HSV1 or is the fact that I have seen no signs tell me that I most likely was exposed to previously ( a little concerned about the stigma of genital over the oral)

2) With this positive for HSV1 how should I react, especially since I have not seen any signs of outbreak
* Stop Kissing
* Stop Sharing drinks
* What about general sex - since I have no idea if it is oral or genital

3) If it is oral what is my risk of spreading it without a break out

I understand that if I have a breakout it will answer the where, but what to do until then especially since I could have gotten this when I was a kid.  

As you can imagine I am really stressing about what type (oral or genital) I could have gotten and then what are the best precautions to take.  Any help would be greatly appreciated.

[Edward W Hook, MD]

Welcome to the Forum.  I'll address your questions. For starters, to be honest, you do not even know that you are infected. While there are fewer data for HSV-1 than for HSV-2.  blood test levels of the sort you report often turn out to be falsely positive results (a well known limitation of the test- that is the reason we recommend against blood testing) and do not reflect true infection.  

Even if you do actually, you can be confident that you did not acquire the infection through the exposure you describe.  HSV-1 is not transmitted by hand to genital contact or in saliva.  Thus IF you are infected, this is a longstanding infection,  statistically most likely to have been acquired in childhood.

As far as what to do with the result, my suggestion is to live your life as you did before you pointed yourself into this corner.  I would not take particular precautions with respect to kissing, shared drinks, or sex.  While there is a theoretical chance you may e infected and could spread it, that chance is low and unless/until you experience an outbreak, I would counsel against changing the way you live your life.

I hope this helps. EWH

[jeff742]

Again thank you for all your help

[Edward W Hook, MD]

All STDs.  EWH

[jeff742]

again thank you for all of your help.  You mention 30 years of hiv work, was that just a typo or was there also focus on hsv?  Either way thanks for all of your help

[Edward W Hook, MD]

Those precautions are mythology and part of the stigma associated with HSV.  I have never seen a case of HSV transmitted in this way in over 30 years of HIV focused practice.  EWH

[jeff742]

Understand, but then why do I also see precautions about not using the same utensils, wash hands to keep from spreading, and don't share a towel.  They appear on sites like webmd.  Would that not be similar to hand to genital contact.

[Edward W Hook, MD]

What you have read it worng- was it on the internet?  HSV is transmitted by direct contact.   EWH

[jeff742]

I have read that hsv1 can be transmitted via salivia or is that only oral to oral?