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Medical Forum / General / General / July 2005

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Herpes Simplex 1

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snowboardkeith@hotmail.com - 08 Apr 2005 04:32 GMT
I have a question (few questions) about HSV-1 that I haven't been able
to find an answer to anywhere.

If over 90% of the population has HSV-1, why do we have to worry about
transmitting it to other people during an outbreak?  How can you
'transmit' it to somebody if everyone already has it?  Doesn't our body
create antigens or antibodies that protect us against the virus after
our initial exposure to it?  If everyone already has HSV-1, how will
being externally exposed to it from another person cause an infection
when the virus is already present, not causing any harm? (i.e. how can
some 'transmit' oral HSV-1 to another's genital by performing oral sex
when that person already has HSV-1?)
Bear - 08 Apr 2005 05:39 GMT
> I have a question (few questions) about HSV-1 that I haven't been able
> to find an answer to anywhere.
[quoted text clipped - 8 lines]
> some 'transmit' oral HSV-1 to another's genital by performing oral sex
> when that person already has HSV-1?)

The numbers I've read show 50% - 80% infected w/ HSV1.  The reason to be
cautious is so you don't spread it to the 50% - 20% (or even 10%) of the
population who doesn't have it.  If you know the person you are with has
it, REALLY know, like, it showed up on blood work, then go nuts.
xyzer@hotmail.com - 08 Apr 2005 05:52 GMT
> > I have a question (few questions) about HSV-1 that I haven't been able
> > to find an answer to anywhere.
[quoted text clipped - 13 lines]
> population who doesn't have it.  If you know the person you are with has
> it, REALLY know, like, it showed up on blood work, then go nuts.

I think his point is that if it doesn't bother most people who have it,
and most people do have it (50% or more), then it doesn't really matter
if the rest of the world gets it.
Bear - 08 Apr 2005 05:57 GMT
>>>I have a question (few questions) about HSV-1 that I haven't been
>
[quoted text clipped - 50 lines]
> and most people do have it (50% or more), then it doesn't really matter
> if the rest of the world gets it.

anyone who doesn't have it, and does get it on their genitals, won't be
really happy

even people who don't have it and get it on their lips won't be really
happy - not everyone who gets it gets cold sores, but they are annoying
and painful

so if someone doesn't have it, it's best to take precautions not to give
it to them
chris - 08 Apr 2005 16:26 GMT
>>>I have a question (few questions) about HSV-1 that I haven't been
>
[quoted text clipped - 50 lines]
> and most people do have it (50% or more), then it doesn't really matter
> if the rest of the world gets it.

xyzer, let me thank you for reminding me why you were in my killfile
before hubby changed my email to Thunderbird and lost all my killfile
settings.  This demonstrates what I feel is an extremely cavilere
disregard for a potential partner's health and well-being.

That said, Even if the current strain is harmless, viruses, bacteria and
other assorted nasties mutate all the time.  Some strains are extremely
nasty.  Look at the bird flu in Asia, for just one example.

I dream of a world where everyone uses barrier methods to prevent spread
of sexually transmitted diseases.  ALL sexually transmitted diseases,
whether relatively harmless or eventually deadly.  Of course, I also
dream of a world where contracting an std is as much concern as going to
the doctor for a quick shot and a bottle of pills or, even better,
getting a set of vaccinations around eight or ten years old.

Deliberately transmitting any disease is ethically WRONG!!!  By
deliberate, I mean not taking sensible precautions.  I cover my mouth
when I cough or sneeze, even when I'm sure it is just alergies that are
not contagious.  I would expect a partner to use a condom if he had any
doubt about his status or mine.  If I had any doubt about my status I
would insist on barrier methods such as condoms to protect him.

A number of years ago, there was talk about making transmission of AIDS
a criminal act.  Haven't followed it.  So knowing your positive std
status and not using safer sex methods, such as condoms or another
barrier, might be a criminal act.  If not, it could potentially be a
civil lawsuit.  If a woman can successfully sue for dumping hot coffee
on herself...

Several reasons why spreading sexually transmitted diseases is not a
good idea.
xyzer@hotmail.com - 08 Apr 2005 18:14 GMT
> >>>I have a question (few questions) about HSV-1 that I haven't been
> >
[quoted text clipped - 53 lines]
> xyzer, let me thank you for reminding me why you were in my killfile
> before hubby changed my email to Thunderbird and lost all my killfile

> settings.  This demonstrates what I feel is an extremely cavilere
> disregard for a potential partner's health and well-being.
[quoted text clipped - 5 lines]
> I dream of a world where everyone uses barrier methods to prevent spread
> of sexually transmitted diseases.  ALL sexually transmitted diseases,

> whether relatively harmless or eventually deadly.  Of course, I also
> dream of a world where contracting an std is as much concern as going to
[quoted text clipped - 3 lines]
> Deliberately transmitting any disease is ethically WRONG!!!  By
> deliberate, I mean not taking sensible precautions.  I cover my mouth

> when I cough or sneeze, even when I'm sure it is just alergies that are
> not contagious.  I would expect a partner to use a condom if he had any
> doubt about his status or mine.  If I had any doubt about my status I

> would insist on barrier methods such as condoms to protect him.

Why would you put someone in your killfile simply for thinking it's ok
to kiss someone without telling them you've ever had a coldsore in your
life?  You'd be putting a lot of people on killfile if you were to
killfile everyone who thought as I do.  You probably killfiled me based
on similar rantings I've done on HPV.

Just to go back to that topic for a second, yearly incidence of genital
warts happens to be around 1% of the pop in the US, and its prevalence
(depending on how you define prevalence of HPV) could be as high as 50%
in this country, with a lenient definition.  THis makes more sense when
you consider that only 1% of those who come in contact with a genital
wart causing HPV strain ever get visible genital warts.  I mean, if you
dislike me so much, then dislike parents who feed their kids crap food,
who smoke around them too much.  Or dislike people who speed too much
on the roads, or who drive sleepily.  I guess my question is who does
more harm:  these forementioned people or those who don't tell others
of ever having had a past cold sore?

You must agree that there comes a point where it doesn't matter really
if tell or not.  Is that point at 80%?  90%?  95%?  97? 99%?  Even you
would agree that if 99% of the population had oral herpes, then it
wouldn't matter if you mentioned that you have had a past cold sore.
But some believe that's true at 80%.  You just might believe it for
99.9%.  Which is necessarily morally superior?
xyzer@hotmail.com - 08 Apr 2005 18:20 GMT
x...@hotmail.com wrote:
<snip>
>THis makes more sense when
> you consider that only 1% of those who come in contact with a genital
> wart causing HPV strain ever get visible genital warts.
<snip>

heh, I of course meant to say "come in contact with a type of
genital-wart causing HPV strand."  For those who come in contact with
actual visible warts, it might be a higher percentage.  I type too fast
I think.
Delila - 08 Apr 2005 12:46 GMT
 >I have a question (few questions) about HSV-1 that I haven't been able
 > to find an answer to anywhere.
 >
 > If over 90% of the population has HSV-1, why do we have to worry about
 > transmitting it to other people during an outbreak?

 Because IF 90% already have it (are you sure it's that high?) that means
10% don't. I don't have it and I don't want it. My coworker is just getting
over a nasty outbreak she had around her mouth. It's nasty to look at and
takes forever to heal.

 D.
FDJIM94@HOTMAIL.COM - 08 Apr 2005 13:10 GMT
try topicla applications of hydrogen peroxide.  I have found that if
you do that as soon as any redness appears it stops the process and
begins the healing.   Gotta stay with it though, 3 times a day or more.
snowboardkeith@hotmail.com - 08 Apr 2005 15:27 GMT
Actually, you most likely do have it.  I believe almost everyone is
exposed to the virus as a child.  Then the virus just lies dormant
(usually) in your nerve cells forever.  Thus, being asymptomatic
doesn't mean you don't carry the virus.  I guess only certain people
have an immune system that can't completely control the outbreaks.
suzee - 10 Apr 2005 14:46 GMT
> Actually, you most likely do have it.  I believe almost everyone is
> exposed to the virus as a child.  Then the virus just lies dormant
> (usually) in your nerve cells forever.  Thus, being asymptomatic
> doesn't mean you don't carry the virus.  I guess only certain people
> have an immune system that can't completely control the outbreaks.

Like Delila (is that who you're replying to? Without quoting, I can't
tell...) I've never had a cold sore in my life and I'm in my 50s. Some
people have very good immune systems and can likely resist a lot of viruses.

sue
Elizabeth - 10 Apr 2005 16:54 GMT
//...snip... I believe almost everyone is
exposed to the virus as a child.  Then the virus just lies dormant
(usually) in your nerve cells forever.  Thus, being asymptomatic
doesn't mean you don't carry the virus.  I guess only certain people
have an immune system that can't completely control the outbreaks.//

Well, as one whose immune system is compromised (not sexually) by a
condition known as fibromyalgia and thus a tendency to catch everything
that's going around, I can say your thesis is incorrect. I've never had
herpes simplex 1.
Tim Fitzmaurice - 11 Apr 2005 13:28 GMT
> Actually, you most likely do have it.  I believe almost everyone is
> exposed to the virus as a child.

Serological data would argue with that. Childhood is a huge point of
infection (I think the largest if I rememebr correctly) but its not the
only one and not to the level of being almost everyone....there's a fair
amount of data showing the spike in prevalence of infection in college
kids in the US -

Hang on just found the paper...Schillinger et al, Sexually Transmitted
Dieseases, 2004, Vol 31, pp753-760. Based off the NHANES III data. It has
68% of the US population aged 12 and over carrying the virus HSV1.
Prevalence increasing with age.

Fleming et al did the same for HSV2 and published in New ENgland Journal
fo Medicine, 1997, Vol 337, pp1105-1111

> Then the virus just lies dormant
> (usually) in your nerve cells forever.  Thus, being asymptomatic
> doesn't mean you don't carry the virus.  I guess only certain people
> have an immune system that can't completely control the outbreaks.

Its not just the immune system but whatever biolgical factors in the virus
and the virus host interactions control coming out of latency. The immune
system doesnt get to the virus till its already reactivated and hoppped
out of the nerves.
Asymptomatic shedding rather makes the point that even if the virus gets
held low enough to avoid lesions, the immmune system of even the
healthiest still lets virus leak out, and quite a lot of the lesion you
do get is the immune systems response anyway. At that point you do have to
wonder how much of the outbreak vs shedding and so on it the host's
control and how much is the virus'.

Tim
--
When playing rugby, its not the winning that counts, but the taking apart
ICQ: 5178568
xyzer@hotmail.com - 08 Apr 2005 18:16 GMT
>   >I have a question (few questions) about HSV-1 that I haven't been able
>   > to find an answer to anywhere.
[quoted text clipped - 8 lines]
>
>   D.

Actually, you don't know if you don't have it.  Most people have it,
but most people don't break out.  I have no idea if I have it, as I
can't remember ever having had a cold sore.  SOme people have better
immune systems than others.  It's also true that many people just can't
say for sure whether or not they have HPV (and that's the truth).  But
be honest.  Do you actually expect future lovers or those who kiss you
to tell you if they remember ever having had a past cold sore?  As a
kid perhaps?  Perhaps they haven't had one in years and just don't
think about that stuff anymore.

I doubt you would expect them to remember it and to tell you.
xyzer@hotmail.com - 08 Apr 2005 18:33 GMT
x...@hotmail.com wrote:
> >   >I have a question (few questions) about HSV-1 that I haven't been
> able
[quoted text clipped - 15 lines]
>
> Actually, you don't know if you don't have it.

<snip>

I like to admit when I'm possibly wrong, and I think I'm wrong here.  I
failed to remember that there's a herpes blood test that tests for
antibodies to HSV, so you may very well know if you don't have it.  I
guess I get in an HPV mindset sometimes.  Sorry!
Delila - 08 Apr 2005 18:52 GMT
 >
 >
 >
 > Actually, you don't know if you don't have it.  Most people have it,
 > but most people don't break out.  I have no idea if I have it, as I
 > can't remember ever having had a cold sore.  SOme people have better
 > immune systems than others.  It's also true that many people just can't
 > say for sure whether or not they have HPV (and that's the truth).  But
 > be honest.  Do you actually expect future lovers or those who kiss you
 > to tell you if they remember ever having had a past cold sore?  As a
 > kid perhaps?  Perhaps they haven't had one in years and just don't
 > think about that stuff anymore.
 >
 > I doubt you would expect them to remember it and to tell you.

 No, I guess I wouldn't. I still hope I never get one of those nasty
outbreaks.

 D.
xyzer@hotmail.com - 09 Apr 2005 01:03 GMT
>   >
>   >
[quoted text clipped - 4 lines]
>   > immune systems than others.  It's also true that many people just can't
>   > say for sure whether or not they have HPV (and that's the truth).
But
>   > be honest.  Do you actually expect future lovers or those who kiss you
>   > to tell you if they remember ever having had a past cold sore?  As a
[quoted text clipped - 4 lines]
>
>   No, I guess I wouldn't. I still hope I never get one of those nasty

> outbreaks.
>
>   D.

Yeah, well I don't blame you for that, but the good news is that even
if you don't have oral HSV and you ever kiss someone who has it, and
you get it, you *probably* wouldn't have many problems with it besides
maybe an initial breakout (if that).  Of course, maybe you would be
someone who would have special problems with it.  Some people do.  A
lot of times these people are stressed out, have immune system
problems, or other types of issues such as winter time.  THen again,
other people who have very bad problems with cold sores might not be
stressed out and have immune systems that are perfectly ok.  Your
co-worker, for example, might not be stressed out or might even get
them in the summer.  But, just be glad that when you consider 50-80% of
the country supposedly has oral herpes, that you don't see very many
people day-to-day who have problems with cold sores.
snowboardkeith@hotmail.com - 08 Apr 2005 15:32 GMT
Can anyone answer the question on whether you can 'transmit' the virus
to someone who already has it?
xyzer@hotmail.com - 08 Apr 2005 21:44 GMT
snowboardke...@hotmail.com wrote:
> Can anyone answer the question on whether you can 'transmit' the virus
> to someone who already has it?

Well, yes, it's possible.  THis is possible because there are different
"strands" of the virus.  Two types are HSV-1 and HSV-2.  To give an
example, someone could have HSV-2 in his or her genital area, but
perhaps not have HSV-1 in his or her mouth or genital area.  If a
person with HSV-1 comes along and licks someone's private area or
kisses someone, then it's possible that that person could spread the
HSV-1 type to the person.

I personally know of a girl who was a virgin who had oral sex done on
her, and she got a breakout of herpes from it.  I obviously don't know
if HSV-1 or HSV-2 was given to her, but, while HSV-2 I've heard "likes"
the genital area more than HSV-1 (and vice versa for oral herpes), I've
heard it's possible that either HSV-1 or HSV-2 can infect either area.
Regardless, it was kind of sad.  She's only ever had one bad breakout,
the first breakout she had.  She's never had a breakout since.  Yet,
her whole relationship was RUINED with this man she loved, yet I'm sure
he didn't even know he had "oral herpes."  They were both young adults
at the time.  Yet, when she went to the doctor and the doctor told her
that she had herpes, she probably thought of him as evil for doing that
to her.  Yet, has it ruined her life?  Not exactly...one bad breakout
originally... none after that.  Yet, a love was lost because of mostly
ignorance and a world that thinks that getting herpes is somehow so
terribly awful.
xyzer@hotmail.com - 08 Apr 2005 21:58 GMT
x...@hotmail.com wrote:
> snowboardke...@hotmail.com wrote:
> > Can anyone answer the question on whether you can 'transmit' the
[quoted text clipped - 22 lines]
> to her.  Yet, has it ruined her life?  Not exactly...one bad breakout
> originally... none after that.

I guess some could argue that if it didn't ruin her life, it definitely
did affect it negatively.  But, isn't that because of the world's
stigma on herpes?  I guess to be fair that's real nonetheless.  And, I
guess I should point out that some people DO have lifelong problems
with herpes, both oral and genital.

I do think that for most though it's not a huge problem, in the sense
that they're constantly having breakouts, either oral or genital.  I'm
not sure breakout rates are the same for oral and genital herpes (so
this might not be an accurate analogy), but if 50-80% of people have
oral herpes, and you don't always see people with cold sores, and only
20-25% of the population has genital herpes, and, assuming the breakout
rates are the same (which again, I'm not sure of), you can see where
it's not a huge problem for the average person who has it --again, not
to say there aren't those that have worse problems with it.
Bear - 08 Apr 2005 22:07 GMT
> snowboardke...@hotmail.com wrote:
>
[quoted text clipped - 27 lines]
> ignorance and a world that thinks that getting herpes is somehow so
> terribly awful.

I think the question was, if someone has HSV1 on their mouth, and you
have it on your mouth, and if you go down on them, can you give it to
them on their genitals?  I'm 99.99% sure you can't, since their body is
already making antibodies for hsv1, but i'd love to here other thoughts
on this
xyzer@hotmail.com - 08 Apr 2005 22:41 GMT
> > snowboardke...@hotmail.com wrote:
> >
[quoted text clipped - 29 lines]
>
> I think the question was, if someone has HSV1 on their mouth, and you

> have it on your mouth, and if you go down on them, can you give it to

> them on their genitals?  I'm 99.99% sure you can't, since their body is
> already making antibodies for hsv1, but i'd love to here other thoughts
> on this

I'm no virulogist, but I think there can be different types of HSV-1 as
well -- mutated types, perhaps?  I don't know.  I could be wrong
though.
snowboardkeith@hotmail.com - 09 Apr 2005 00:29 GMT
I thought there were multiple strains of the HSV-1 also, but my doctor
told me that there aren't.  Although I doubt I should trust anything he
says regarding herpes. He told me the "HSV-1 stays above the waist and
HSV-2 stays below the waist," line, which apparenly USED to be accepted
knowledge among doctors.  However, now that seems to be completely
false (verified by my online research).  I guess my doctor needs to get
up-to-date.
Enuf - 10 Apr 2005 04:01 GMT
> I thought there were multiple strains of the HSV-1 also, but my doctor
> told me that there aren't.  Although I doubt I should trust anything he
[quoted text clipped - 3 lines]
> false (verified by my online research).  I guess my doctor needs to get
> up-to-date.

This is what I was told by my Dermatologist also. HSV1 is oral and HSV2
is genital.

I was also told that the HSV1 virus is acquired as a child and it
remains dormant until you become an adult. If you don't acquire it as a
child, it is very rare that you will acquire it later in life (immunity
factor?). This would explain why the virus is not passed during
kissing.

HSV1 is not confined to the lip area.  I have had it occur as low as
the chin or as high as a cheek. I also know an individual who lost
eyesight in one eye from HSV1.

HSV1 & HSV2 responds very quickly to the drug Valtrex if taken at the
first sign of itching/burning. A 2-3 week normal run of outbreak can be
reduced to 1-3 days.

Enuf
(who has battled oral HSV1 for 45 years)
xyzer@hotmail.com - 10 Apr 2005 05:11 GMT
> > I thought there were multiple strains of the HSV-1 also, but my
> doctor
[quoted text clipped - 11 lines]
> This is what I was told by my Dermatologist also. HSV1 is oral and HSV2
> is genital.

Technically, also less likely, it is possible to have HSV-1 in the
genital area as well, as well as HSV-2 in the oral area.

> I was also told that the HSV1 virus is acquired as a child and it
> remains dormant until you become an adult. If you don't acquire it as a
> child, it is very rare that you will acquire it later in life (immunity
> factor?). This would explain why the virus is not passed during
> kissing.

Are you sure about this?  Where did you hear this from?  Not saying
you're wrong necessarily, but I've never heard that, if you don't have
oral herpes as an adult, that it's very rare to get as an adult if
you're exposed to it.  Again, I know of a girl who got an outbreak of
genital herpes from having oral sex performed on her (she was a
virgin).  

<snip>
Enuf - 10 Apr 2005 20:18 GMT
> Are you sure about this?  Where did you hear this from?  Not saying
> you're wrong necessarily, but I've never heard that, if you don't have
> oral herpes as an adult, that it's very rare to get as an adult if
> you're exposed to it.  Again, I know of a girl who got an outbreak of
> genital herpes from having oral sex performed on her (she was a
> virgin).

Am I sure? No. As I said, this is what I was told by a doctor years
ago. And bear in mind I was referring to the oral-to-oral HSV1, not the
genital variety which is a whole different ballgame. In fact all HSV is
now a whole new ballgame since virus mutates fairly rapidly depending
on where it takes up residence.

Enuf
Tim Fitzmaurice - 11 Apr 2005 13:15 GMT
>> I thought there were multiple strains of the HSV-1 also, but my
> doctor
[quoted text clipped - 11 lines]
> This is what I was told by my Dermatologist also. HSV1 is oral and HSV2
> is genital.

Thats a long long way out of date. These days about 1 in 3 new cases in
the US of genital herpes turns out to be HSV1, not HSV2. HSV2 does not
seem to be migrating to the oral area to the same extent...my guess if I
had to put money on it would be that that is due to the different level of
response to a genital vs oral infection brings about plus the general
level of care about STDs thats been in the population in the last 30 years
or so.

> HSV1 is not confined to the lip area.  I have had it occur as low as
> the chin or as high as a cheek. I also know an individual who lost
> eyesight in one eye from HSV1.

Yup, it will potentially go anywhere the infected nerve ganglion
innervates.

Tim
--
When playing rugby, its not the winning that counts, but the taking apart
ICQ: 5178568
Mark - 11 Apr 2005 13:43 GMT
> Can anyone answer the question on whether you can 'transmit' the virus
> to someone who already has it?

.
Good data is available at http://www.herpes.org/ (this site also
discusses HPV) and http://www.herpes.org.uk/ (run by herpes "sufferers")
- there are undoubtedly other sources of information.
.
First myth to dispel - HSV-1 is not purely above the waist and HSV-2 is
not purely below the waist, you can get HSV-1 genitally and HSV-2 orally.
.
They tend to be happier in those contexts, according to recent
information from G-U medical specialists -  this seems to mean that if
you get HSV-1 genitally, you'll probably have one (quite unpleasant)
episode but once your immune system gets on top of it, you probably
won't have another major episode.
.
Anti-virals tend to get on top of it quite well during that first
outbreak and will also be useful for controlling later outbreaks.
If you have an ongoing HSV problem - lots of outbreaks, it's worth
consulting a physician and trying anti-viral treatments (orally, not
just creams).
.
I've also been told (by a specialist I was consulting) that although
it's possible, contracting HSV-2 by oral contact is frankly unheard of.
Transmitting HSV-1 from mouth to genitals is possible and not uncommon.
.
Having one form of HSV tends, apparently, to protect against the other -
the specialist told me that animal experiments attempting to doubly
infect were almost invariably unsuccessful. Don't rely on this to avoid
infection, however.
.
Other interesting points - HSV is a very successful virus, found in
almost all animals from molluscs upwards; My specialist remarked that
outbreaks are, from the virus' point of view, a bad thing - the ideal
for the virus is to be present for infection without exhibiting
symptoms; In general, HSV tends to become less of a problem the longer
you have it.
.
Hope that's interesting and helpful.
suzee - 11 Apr 2005 15:18 GMT
>>Can anyone answer the question on whether you can 'transmit' the virus
>>to someone who already has it?
[quoted text clipped - 36 lines]
> .
> Hope that's interesting and helpful.

Yes it is, thanks.

sue
Tim Fitzmaurice - 11 Apr 2005 13:45 GMT
> Can anyone answer the question on whether you can 'transmit' the virus
> to someone who already has it?

The basic answer always used to be no, with the detailed answer running
down to a complex set of variables that suggested that its a) very
difficult but possible and b) may not make a great deal of difference
long term as it may not really be able to colonise terribly well.

If you hunt in the literature you will find papers like
The latency-associated gene of herpes simplex virus type 1 (HSV-1)
interferes with superinfection by HSV-1.
J Neurovirol. 2002 Dec;8 Suppl 2:97-102.

These obviously point out that the virus has evolved to try to avoid
superinfection happening. Superinfection has been described in the eue but
that is an immune privileged site.

As ever with this virus, it aint that simple and a lot of the issue is
what tools were available. Now you see the papers like this one
Roest et al, Journal of Medical Virology, vol 73, p 601-604. It is
entitled 'Genotypic analysis of sequential genital herpes simplex virus
type 1 (HSV-1) isolates of patients with recurrent HSV-1 associated
genital herpes'

They took a smallish number of patients, and sequenced the DNA of virus
got from swabs from patients sequentially. In 3 of their 13 subject the
sequence differed in a region known to be variable bewteeen HSV1 strains.
This suggests that those individual had more than one strain, raising the
possiblility of having been infected there mnore than once. That
immediately raises the possiblility of someone with HSV1 in the oral site
getting it in the genital....
(Note this is looking at strains of HSV1, NOT HSV1 vs HSV2 which are two
seperate viruses and have different interactions where one can clearly infect
someone with the other).

However I dont think how big a possiblity that is and what that means in
terms of changes in how you suffer or not from HSV in you has been
established. The basic line of 8 or 9 of 10 infections doesnt produce
symptoms still holds true and presumably will hold on these
superinfections too (if it isnt even more difficult). The 2 roughly 1 in
10s there sort of pulls about 1 in 100 infected people having to deal with
it as a sort of thrown together guess (but it is just an extrapolated
guess)

So I think it boils down to possible, but difficult to get more than one
virus strain in you, and not really well established if it changes what
happens to you if you do get superinfected...does it add to the issue,
does it just follow the other pattern etc.

Tim
--
When playing rugby, its not the winning that counts, but the taking apart
ICQ: 5178568
xyzer@hotmail.com - 09 Apr 2005 00:42 GMT
> I have a question (few questions) about HSV-1 that I haven't been able
> to find an answer to anywhere.
[quoted text clipped - 8 lines]
> some 'transmit' oral HSV-1 to another's genital by performing oral sex
> when that person already has HSV-1?)

I realize I'm probably posting too much in here, but just to give you a
taste of how much a lot of people don't know about herpes, read this
Mike Vick fan blog (don't have to sign in to read their posts).

http://tinyurl.com/4oydl

This is their reaction to him and his herpes lawsuit.  One poster even
wonders how people with herpes can even play football.  Perhaps he has
the misconception that people with herpes actually have sores all the
time.  He or she wonders why they don't "check for that" in the yearly
physicals.  I don't mean to be hard on these people too much, but when
people aren't educated about things, that's when things get to be
overblown.
PF Riley - 10 Apr 2005 19:41 GMT
>I have a question (few questions) about HSV-1 that I haven't been able
>to find an answer to anywhere.
[quoted text clipped - 8 lines]
>some 'transmit' oral HSV-1 to another's genital by performing oral sex
>when that person already has HSV-1?)

It's amazing how many misconceptions and misunderstandings about HSV
have been echoed on this thread alone let alone on the internet at
large.

Herpes simplex is a virus well adapted to humans. There are two main
types. It is nonsense that HSV-1 "only" infects the mouth and HSV-2
"only" infects the genitals. Anyone who believes this and willingly
receives oral sex from a person with a mouth full of cold sores may be
in for an unpleasant surprise.

The difference is that HSV-1 more easily reactivates in the oral
region, and HSV-2 more easily reactivates in the genital region. This
is why that majority of oral cases are HSV-1 and genital cases are
HSV-2. However, cross infections can and do occur and are not at all
rare.

Next, the prevalence of antibodies to HSV-1 varies among the
population selected, generally from 30% to 80%. "Over 90%" is a gross
overestimation. With HSV-1, many who acquire it either have no
symptoms at all, or had the primary infection manifest as herpetic
gingivostomatitis in young childhood, which most people will not
remember. It is only a certain percentage of people thereafter who
have recurrent cold sores. The others remain unaware that they have
had HSV-1.

Antibodies levels, however, are not the best surrogate marker for
actual immunity. One may indeed have protective immunologic memory for
HSV-1 but undectable antibody levels (although unlikely), and another
may have HSV-1 antibodies from an oral infection in childhood which
may not protect him from herpetic keratitis should someone with a cold
sore spit in his eye.

In other words, someone who has known HSV-1 antibodies could also be
in for an unpleasant surprise if they believe they are completely
protected from any further infections. It is well known that
varicella, which is a herpes virus as well, can infect people twice,
and so can HSV.

Finally, someone's suggestion that Valtrex can shorten an outbreak
from several weeks to several days is wishful thinking. It shortens
the duration by at most 1 or 2 days, only if started immediately at
the first tingling sign of an outbreak. If vesicles have already
started forming, it pretty much does nothing.

PF
xyzer@hotmail.com - 11 Apr 2005 22:23 GMT
<snip>
> It's amazing how many misconceptions and misunderstandings about HSV
> have been echoed on this thread alone let alone on the internet at
> large.
<snip>

Yup, the worst part about having herpes by far I would think would be
having to face an ignorant world.  If you *really* think about it, it
seems *really* silly that others would expect a potential sex partner
who's ever had a past herpes breakout to admit it to the other patner.
Most people already don't admit it for oral herpes and aren't thought
of as being selfish or bad for doing so.  However, I guess the reason
people expect others simply to admit to having had a genital herpes
infection in the past is because they know others will expect them to
tell if they get it and that the world is basically being kind of
silly.  I guess that's a valid enough reason, but it kind of pisses me
off still.
Matt Beckwith - 10 Jul 2005 04:07 GMT
>Yup, the worst part about having herpes by far I would think would be
>having to face an ignorant world.  If you *really* think about it, it
>seems *really* silly that others would expect a potential sex partner
>who's ever had a past herpes breakout to admit it to the other patner.

I'm amazed that anyone would think this way.  You seem to be saying
that it's silly that people would expect other people to have
integrity.

Does this mean that you think it's okay to have sex with someone and
give him/her herpes without prior notification of your disease?

If so, are you aware that this is a crime?
Enuf - 12 Apr 2005 15:49 GMT
> Finally, someone's suggestion that Valtrex can shorten an outbreak
> from several weeks to several days is wishful thinking. It shortens
[quoted text clipped - 3 lines]
>
> PF

Bull!! I've had outbreaks of oral HSV for 45 years so I have a great
amount of experience in every conceivable treatment for it. If Valtrex
is taken at the first sign if symptoms (itching/burning), vesticles do
not form. Thus the "outbreak session" is limited to days instead of
weeks. Period! Based upon true experience instead of hearsay!

In all fairness, however, there is variation on how Valtrex is
prescribed. Some doctors prescribe 1 pill twice a day for 4 days. This
delays the drug's action and could result in a longer recovery time.
The newer prescription is 2 pills twice a day for 1 day. This gets more
drug to the infected site a lot faster and results in a faster
response/faster recovery.

Enuf
PF Riley - 13 Apr 2005 05:04 GMT
>> Finally, someone's suggestion that Valtrex can shorten an outbreak
>> from several weeks to several days is wishful thinking. It shortens
[quoted text clipped - 7 lines]
>not form. Thus the "outbreak session" is limited to days instead of
>weeks. Period! Based upon true experience instead of hearsay!

Here is what you said:

"HSV1 & HSV2 responds very quickly to the drug Valtrex if taken at the
first sign of itching/burning. A 2-3 week normal run of outbreak can
be reduced to 1-3 days."

You did NOT say, "In my experience, a 2-3 week normal run of outbreak
can be reduced to 1-3 days, but this may not be the case for others."
I would have had no problem with that statement.

What is objectionable is your implication that this can be expected
for anyone. You readily admit, when challenged, that this is based
only on your own personal experience (basically an uncontrolled study
with one subject), and is thus meaningless. Flonase did nothing for my
allergic rhinitis -- should I shout "Bull!!" at my patients who tell
me Flonase helps them? (And by the way, shouting "Period!" and using
exclamation points does not make your argument more tenable.)

>In all fairness, however, there is variation on how Valtrex is
>prescribed. Some doctors prescribe 1 pill twice a day for 4 days. This
>delays the drug's action and could result in a longer recovery time.
>The newer prescription is 2 pills twice a day for 1 day. This gets more
>drug to the infected site a lot faster and results in a faster
>response/faster recovery.

You didn't mention that there are two dosing strengths (500 mg and
1g). But, anyway, since you accuse me of reporting "hearsay", here's
what GSK has to say in their package insert about the "newer"
prescription for recurrent oral HSV:

>Cold Sores (Herpes Labialis): Two double-blind, placebo-controlled
>clinical trials were conducted in 1,856 healthy adults and adolescents
[quoted text clipped - 10 lines]
>VALTREX or placebo in the prevention of progression of cold sore
>lesions beyond the papular stage.

Let's see... almost 2,000 people starting treatment (using "2 pills"
twice a day) within 2 hours of symptoms... before a cold sore
develops... shortened the episode by about 1 day. Now let me think...
what did I say earlier? Oh yes: "It shortens the duration by at most 1
or 2 days, only if started immediately at the first tingling sign of
an outbreak."

PF
Enuf - 13 Apr 2005 16:09 GMT
> What is objectionable is your implication that this can be expected
> for anyone. You readily admit, when challenged, that this is based
> only on your own personal experience.

Guilty.

As are you when you said "Finally, someone's suggestion that Valtrex
can shorten an outbreak from several weeks to several days is wishful
thinking. It shortens the duration by at most 1 or 2 days, only if
started immediately at the first tingling sign of an outbreak. If
vesicles have already started forming, it pretty much does nothing."

You also inferred that those results apply to everyone, which I
objected to. We both know medications work differently on different
people. Since we both are guilty of not adding a disclaimer, case
closed for Valtrex usage.

On a related note, however, let me share a "personal experience" on
treating an oral outbreak if Valtrex doesn't work. I have found that
applying a high % alcohol solution to the vesticles for a few days
cauterizes them and reduces the duration by several days.
(Disclaimer: Not everyone can expect the same results.)

Enuf
 
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