HSV1 - questions about test results

[mbrian]

I have few questions to Dr. H. Hunter Handsfield, M.D. about HSV-1.

Hello Dr. Handsfield,

I was recently diagnosed with HSV-1 virus. The following are my test results, (performed at anylabtestnow center)

HSV 1/2 IGG, HERPESELECT TYPE SPECIFIC AB

HSV 1 IGG Type specific AB - > 5.00H

HSV 2 IGG Type specific AB - < 0.90

I have never experienced any symptoms of this disease in my entire life. I have not been sexually active so far because of my study and career. However, I had protected sex one month ago but I never gave oral to anyone in the past and never had unprotected sex. However I have received unprotected oral sex 2-3 times in last 2 years.
So is it possible that I might have gotten this from those 2-3 times or I got this in my childhood? but I don't remember of any cold sore from my childhood either.

And is it possible that it could be a false positive?

And for future,

Could I pass this to my future wife if I have unprotected sex with her? Or by kissing her mouth or nippular area or by oral sex? I don't even know the site of preference of this virus in my body so how can I prevent this from spreading to others?
And also if I plan to have a baby then what are the risks for that? I don't want to spoil someone's life because of this disease. I am really frustrated.

I was reading lot about this disease ever since I was diagnosed positive with this (one week ago) and some articles say that HSV1 is more dangerous than HSV2 because it can reoccur spontaneously in the eye or brain. There have been 400,000 cases of ocular herpes in united states alone so I am really scared about this now.

Do you expect any cure in future for this?

I would appreciate if you could give me some information about this. In last one week, I have gone to my primary care doctor and one other infectious disease doctor and they found no symptoms in my mouth, or genital area or anywhere else.

Please let me know your insights on this.

Thanks for your time.

[ladyd22666]

A related discussion, hsv 1 was started.

[mbrian]

I was just curious because I was under the assumption that doctors are generally far far away from diseases because they know about diseases and take good care of them but I guess they are also human being:) It was just a curiosity that's all.

Anyway I want to thank you for answering all my questions!

Take care doctor...

[H. Hunter Handsfield, M.D.]

Presumably about half of all physicians have HSV-1.  Off the top of my head I am aware of a colleague who has recurrent oral herpes outbreaks, but I'm sure there are many I don't know about.  But how is this pertinent?

[mbrian]

Thanks for the clarification doctor. I truly appreciate your response.

Just a curiosity, as you know half of all the adults in US are infected with this disease. I am sure, you must have treated all kind of patients, have you ever seen any doctors too in your career who have been infected by this?

It is just a curiosity, I think now it is not a big deal..:)

Regards,
Brian

[H. Hunter Handsfield, M.D.]

1) There might be a risk of transmission by the routes you describe, but they are very low.  In general, HSV-1 (unlike HSV-2) probably is usually transmitted by people with overt, symptomatic outbreaks -- not from asymptomatic infection.  Most HSV-1 infected people never know it, yet most of their sex partners never catch it.  If in the future you develop symptomatic outbreaks of cold sores or, less likely, genital herpes, avoid sexual contact when sores are present.  Otherwise, this isn't worth a second thought.

2) Physical workouts or diet make no difference.  Sunburn is a common trigger for oral herpes outbreaks, but if it has never happened to you, most likely it never will.

3) I don't expect there will ever be a cure for HSV, certainly not in the next several years.

Having HSV-1, you are just like half of all adults in the US.  Have you ever heard of anybody as worked up over it as you are?  Please let it go.

That's all for this thread.

[mbrian]

Hello doctor,

Thanks for the information... That was a relief...
The reason I asked was, I might start a new relationship soon and wanted to know about this as mush as I can so that I can prevent this from spreading to my potential partner in future. But I would still like to ask,
1) Is there any chance that I can put my partner at risk by kissing on her mouth, nippular areas or by oral or unprotected sex knowing that I have no symptoms at all?
2) The other thing is, my job has lot of physical excercise so do I need to worry about things like, tough workout, sun exposure etc... and do I need any special diet?
Because so far I have lived my life fully every second and won't like to change that because of this.
3) Do you expect any cure for this in near future?

I appreciate your response and time on this.

Thanks & Regards,

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  But first, so you and other forum users understand how the forum works:  It is only by chance that I took your question.  Dr. Hook and I take questions interchangably and pay no attention to specific requests for one of us or the other.  Our professional advice and opinions have never disagreed substantially, however.

You are overreacting in a big way to a trivial problem.  Positive HSV-1 tests are almost never false, particularly with strongly positive results like yours.  You have HSV-1.  So do half of all adults in the US and up to 90% of people in some countries.  The lack of symptoms is typical; most infected people have no recollection of symptoms of either oral or genital herpes.  Unless you develop symptoms in the future -- which you probably will not -- you will never know whether your infection was oral or genital.  But the majority of HSV-1 infections are oral, most commonly acquired in childhood.

You are not at risk for ocular herpes.  I can't count on the accuracy of your figure of 400,000 US residents who have it.  But if so, that means about 1 in every 900 Americans, or 1 in 450 among those with HSV-1.  And most ocular herpes occurs at the time of the first infection; almost nobody with chronic HSV-1 later develops herpes of the eye.  Look at it this way:  Half of all people you know have HSV-1.  Have you ever known anyone with herpes of the eye?  The risks to any future babies you may have are even lower.

You need to just forget about this.  It is a meaningless aspect of your life and almost certainly will remain so.  Stop seeking health care about it.

Regards- HHH, MD