Asymptomatic transmission - Oral Versus Genital HSV-1

[logicgirl]

After the numberous hours of reading, I have done, I find two questions unanswered.
1:) ASHAD states that oral HSV-1 sheds approximately 5% of the days.  Also stated is HSV "looses its punch" when located out of it's preferred state i.e. genital HSV-1.
Therefore, wouldn't it be true transmission of asymptomatic oral HSV-1 is more likely to be passed on unknowlingly then asymptomatic genital HSV-1?

2:) Are there any studies that have researched recurrent genital HSV1 past 3 years?

I had a symptom once of Genital HSV 1 but it was never diagnosed with a culture.  Later, I received blood tests that confirmed HSV1 positive and HSV2 negative.  I have never seen any recurrent lesions in 7 years since the so thought first episode.


This discussion is related to Genital HSV 1 Transmission.

[logicgirl]

When I had my 1st and only symptoms 7 years ago of ghsv I obviously was scared to death.  I had been in a relationship for 3 years and have always been extremely careful about protection.  Again, no culture was performed by planned parenthood at the time but the assistant said it was hsv.
However, later I had blood work which confirmed (and has since confirmed) that i am hsv1+ and hsv2-.  My bf at the time didn't have visible cold sore's but later told me he sometimes gets a '***** sore' inside his mouth - which I wouldn't have seen.
My question is how do they know that 50% of ghsv1 people never have another ob if the studies haven't exceeded three years?  My dr thinks I'm being a little too concerned but I am extremely careful about my health and must do the same for my partner.  
This is an extremely hard thought for me to cope with as I have been so careful over the years.  What are the odds right?
What sparked this thought process again recently, is that I thought I had symptoms again - to me it looked very like hsv - but my dr performed a swab and it was negative.  However, now I keep thinking about the situation 7 years ago and am stressing out!  I always thought planned parenhood had made a mistake but now i'm not so sure.

Lastly, how confident are you about the new research being performed by Dr. Cullen at Duke on HSV1?  http://www.genomeweb.com/rnai/embl-exiqon-cenix-cellcentric-duke-university-harvard-university

[auntiejessi]

Sorry - hit submit too soon.

Frequency of obs really depends on the person, but on average, someone with ghsv1 will only get an ob once every other year or so, if they get any at all.

Here are some things to read -

http://www.herpes.com/hsv1-2.html - this is an old article, and some of the data is out of date, but you get a good idea of how each type works in each place.  

Herpes handbook - www.westoverheights.com

www.ashastd.org - click on herpes

We also have a great herpes forum here you should check out.

[auntiejessi]

The 50% with no recurrences was for genital hsv1, not oral hsv1.  We do know that about 60-80% of the population has hsv1 orally, and of those, only about 20-40% will ever get an outbreak.

[logicgirl]

Good news.  It makes sense that oral hsv1 would be easier to transmit genitally then genital hsv1.  What did you say the percentage of people with hsv1 in the US is?
I'd be curious to know how they got 50% never have a second ob.  Is it also true for ghsv1 that if one does get ob's, they will become less and less over time?

Thanks for your reponses.

[auntiejessi]

1 - Absolutely.  GHSV1 is rarely transmitted.  I'd say that ohsv1 sheds more than that - where did you see that stat of 5% on asha?  The herpes handbook at www.westoverheights.com puts it at 18%.

2 - We have very few studies on ghsv1.  We do know that if you have it, you have a 50% chance of never getting another outbreak, and you are not at all likely to transmit it.

Here is an article by Terri Warren (who wrote the handbook, and is now our herpes expert here) - http://blogs.webmd.com/genital-herpes-intimate-conversations/2006/02/type-i-herpes-transmission.html

Aj