I Can`t Recall ever Having a Herpes Outbreak

Dear Dr. Tom:

I tested 1.27 HSV-1 and 4.08 for HSV-2. I`m a 63 year old male in excellent health. I can`t recall ever having an outbreak of any lesions/ sores etc. in the genital area but had a cold sore on my lip about 6 weeks ago after spending several afternoons in the sun. I probably have experienced these very infrequently in the past but this time got tested with the results noted above. Q =testing positive for HSV-1, do I necessarily have genital herpes, and if so, can I TRANSMIT it even though there?s been no oral outbreaks. Is HSV-1 oral still genital herpes? Do I pass it on orally only ? My doc was of little help and what he did convey doesn`t track to me.

Dr. Tom’s Response:

Dear Anonymous:

Herpes simplex viruses are widely classified as types 1 and 2. Type 1 infects primarily the oral cavity, lips, and sometimes the face and other upper body parts. Type 2 infects mostly the genital area and areas below the waist. The viruses haven’t read the rulebooks, and sometimes move around. Type 1 on the genitals or related areas is considered genital herpes. Type 1 oral is not genital herpes. The reverse is true. Type 2 virus can appear on the lips, face, oral cavity and can cause herpetic sore throat. Herpes type 2 lesions have been known to appear on the face and lips of man after performing cunnilingus on a partner who has genital herpes. You may be able to transmit even though there is no outbreak, because some infected persons are asymptomatic shedders of the virus. The recent cold sore was quite likely a manifestation of Type 1 virus and is strongly suggestive that you can transmit orally. If you have had only cold sores and no genital lesions you probably do not have genital herpes. The results you gave indicated that you have both virus types in your body, hence should be considered capable of transmitting either.


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