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Asymptomatic Shedding hsv-1
Dear Doctor
Thank you for your valuable time. Here is my background
I am a male in my early 40s. March 9,2008 gf had a cold sore. i got my blood work done March 25,2008. April 25,2008 immunoblot igg blood test results came back hsv-1positive & hsv-2 negative. no igg value was listed (i live in toronto). since then i will have tingling and burning lips pretty much every week. i apply 5%zovirax and take 1gram of valtrex everytime i feel something is coming on. i do not ever recall seeing any sores of any kind. up til now i still dont know where the infected site is on my body. i did the blood test again in 2009 and same results came back.here are my questions
1. can i trust the test results with no lesions ever?
2. assuming my hsv-1 is on my lips and i touch my lips during Asymptomatic Shedding then touch my body everywhere. would i be then spreading the virus and have sores every where on my body?
3. if my hsv-1 is gential and is shedding the virus with no sores, would i re trigger my gf's coldsore after she performed oral sex on me?
4. whats the risk for me getting gential hsv-1 from gf performing protected oral sex on me including unprotected scrotum licking when she is shedding the virus with no symptoms?
5. when i do get sores, should i expect a nasty first espisode?
Thank you again Doctor for your help.
Thank you for your valuable time. Here is my background
I am a male in my early 40s. March 9,2008 gf had a cold sore. i got my blood work done March 25,2008. April 25,2008 immunoblot igg blood test results came back hsv-1positive & hsv-2 negative. no igg value was listed (i live in toronto). since then i will have tingling and burning lips pretty much every week. i apply 5%zovirax and take 1gram of valtrex everytime i feel something is coming on. i do not ever recall seeing any sores of any kind. up til now i still dont know where the infected site is on my body. i did the blood test again in 2009 and same results came back.here are my questions
1. can i trust the test results with no lesions ever?
2. assuming my hsv-1 is on my lips and i touch my lips during Asymptomatic Shedding then touch my body everywhere. would i be then spreading the virus and have sores every where on my body?
3. if my hsv-1 is gential and is shedding the virus with no sores, would i re trigger my gf's coldsore after she performed oral sex on me?
4. whats the risk for me getting gential hsv-1 from gf performing protected oral sex on me including unprotected scrotum licking when she is shedding the virus with no symptoms?
5. when i do get sores, should i expect a nasty first espisode?
Thank you again Doctor for your help.
A related discussion, western blot question was started.
MEDICAL PROFESSIONAL
My opening comment should have been "since you live in Canada", not "if you live in the US". The epidemiology of HSV-1 is more or less the same in both countries. For people in their 40s, it's closer to 60% of the population that has HSV-1, not 50%. You are part of the majority.
And one more thing that goes back to your overall reaction to this situation: It was not unreasonable for you to be tested for HSV-1 after your gf showed evidence of having oral herpes. However, your reaction to the result was the opposite of what was appropriate. If you had tested negative for HSV-1, you would have had to worry about catching it from your partner. Your result is good news, not bad, since it shows you're already infected and won't get it again; and in the absence of symptoms, it is probable you'll never have any.
And one more thing that goes back to your overall reaction to this situation: It was not unreasonable for you to be tested for HSV-1 after your gf showed evidence of having oral herpes. However, your reaction to the result was the opposite of what was appropriate. If you had tested negative for HSV-1, you would have had to worry about catching it from your partner. Your result is good news, not bad, since it shows you're already infected and won't get it again; and in the absence of symptoms, it is probable you'll never have any.
MEDICAL PROFESSIONAL
Welcome to the STD forum. I reviewed your discussion with Terri on the herpes forum and agree with her responses.
My first advice is for you to put your HSV-1 infection into perspective. You are way overreacting to an entirely normal human circumstance. If you live in the US, you're just like half of all adults. Most of them don't know of their infections. The vast majority never have a health problem from it and do not transmit the infection to anyone else. That you happen to have learned of your HSV-1 infection does not change anything in any important way -- or should not.
It is extremely unlikely your oral symptoms are due to herpes and I recommend you stop using the acyclovir ointment. When people have recurrent oral herpes outbreaks, the average frequency is once or twice a year, and herpes does not cause the very frequent or nearly continuous tingling symptoms you describe. If you ever develop real herpes symptoms -- an actual outbreak of blisters/sores on the face (usually near the lips), see your dermatologist to confirm whether it indeed is herpes.
To your specific questions:
1) Positive type-specific HSV blood tests are highly reliable. For sure you are infected with HSV-1. Like you, most such persons have no recollection of symptoms that suggest herpes, either oral or genital. Statistically, it is most likely your infection is oral and you have had it since childhood.
2) Your dermatologist was wrong. Once someone is infected with HSV of either type, s/he is immune -- or at least highly resistant -- to a new infection with the same type, anywhere on the body. Transfer of infection to a new part of the body is called auto-inoculation and it is very rare; it occurs sometimes during the very first herpes infection, but rarely if ever occurs in people with longstanding infection. You shouldn't be at all worried about it.
3) If your gf has oral herpes, then she already has HSV-1. For the reason just explained, she cannot catch it again. It is not possible for you to infect her with your HSV-1 infection either on her mouth or genital area.
4) There is little or no chance you will catch genital HSV-1 from your partner, for the same reason. It always makes sense for people with herpes outbreaks, whether oral or genital, to avoid kissing or having sex in a way that allows contact of the lesion with the other person. But that's just a common sense precaution that probably doesn't actually make much difference.
5) Severe ("nasty") herpes is pretty much limited to the first infection, which in your case probably occurred 30 or more years ago. In people with longstanding infeciton, the first recognized outbreak is usually mild, just like any recurrent episode.
Bottom line, repeating my opening comment: You should be having no worries about your HSV-1 infection. Stop the acyclovir ointment and see your dermatologist if you actually get an oral herpes outbreak. Most likely you never will. Don't worry about sex with your girlfriend -- except use common sense and avoid direct contact any time either of you has an obvious herpes lesion.
Best wishes-- HHH, MD
My first advice is for you to put your HSV-1 infection into perspective. You are way overreacting to an entirely normal human circumstance. If you live in the US, you're just like half of all adults. Most of them don't know of their infections. The vast majority never have a health problem from it and do not transmit the infection to anyone else. That you happen to have learned of your HSV-1 infection does not change anything in any important way -- or should not.
It is extremely unlikely your oral symptoms are due to herpes and I recommend you stop using the acyclovir ointment. When people have recurrent oral herpes outbreaks, the average frequency is once or twice a year, and herpes does not cause the very frequent or nearly continuous tingling symptoms you describe. If you ever develop real herpes symptoms -- an actual outbreak of blisters/sores on the face (usually near the lips), see your dermatologist to confirm whether it indeed is herpes.
To your specific questions:
1) Positive type-specific HSV blood tests are highly reliable. For sure you are infected with HSV-1. Like you, most such persons have no recollection of symptoms that suggest herpes, either oral or genital. Statistically, it is most likely your infection is oral and you have had it since childhood.
2) Your dermatologist was wrong. Once someone is infected with HSV of either type, s/he is immune -- or at least highly resistant -- to a new infection with the same type, anywhere on the body. Transfer of infection to a new part of the body is called auto-inoculation and it is very rare; it occurs sometimes during the very first herpes infection, but rarely if ever occurs in people with longstanding infection. You shouldn't be at all worried about it.
3) If your gf has oral herpes, then she already has HSV-1. For the reason just explained, she cannot catch it again. It is not possible for you to infect her with your HSV-1 infection either on her mouth or genital area.
4) There is little or no chance you will catch genital HSV-1 from your partner, for the same reason. It always makes sense for people with herpes outbreaks, whether oral or genital, to avoid kissing or having sex in a way that allows contact of the lesion with the other person. But that's just a common sense precaution that probably doesn't actually make much difference.
5) Severe ("nasty") herpes is pretty much limited to the first infection, which in your case probably occurred 30 or more years ago. In people with longstanding infeciton, the first recognized outbreak is usually mild, just like any recurrent episode.
Bottom line, repeating my opening comment: You should be having no worries about your HSV-1 infection. Stop the acyclovir ointment and see your dermatologist if you actually get an oral herpes outbreak. Most likely you never will. Don't worry about sex with your girlfriend -- except use common sense and avoid direct contact any time either of you has an obvious herpes lesion.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
