Dr. Rob answers questions about herpes

Do you have any questions or concerns about what Herpes is, how it's spread, about the virus itself?
Receive advice from Dr. Rob Keller, a Doctor who devoted much of his life to the study of viruses and Sexually Transmitted Diseases.



Dr. Rob explains

20% of oral herpes is transmitted genitally

Question...

Some co-workers of mine were debating the issue of herpes. 
One of them believes that everyone carries the strain of 
herpes within their body. The other believes that you have 
to come into contact with herpes from another source in 
order to get it. I am quite confused and don`t know who to 
believe, could you help me with this.
From: Confused in Carolina

Dr Rob's reply...

Dear Confused in Carolina:

Very good question!  You do not "carry" herpes; you  
"contract" herpes from someone else or something. 

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Question...


I have a couple of questions, I`ve had HSV1 cold sores on 
my lips all my life, so I`ve been a little paranoid about 
contracting genital herpes now that I am older.   About two 
years ago, I had some redness after sexual intercourse and I 
went to see my doctor.   The redness had no lumps or lesions, 
which I characteristically would see with my HSV1 infections 
along with no pain or real itching.  My question is would a 
herpes genital infection look and feel much like an infection 
I am used on my lips?   I went back to the doctor just because 
I wanted piece of mind...at my earlier visit he dismissed the 
redness as irritation and said it was not typical of a Herpes 
infection.    I had a HSV1/HSVII type specific blood test 
done for piece of mind, but the only issue is obviously the 
HSV1 would come back positive for antibodies because I 
have had HSV1 cold sores on my lips all my life; HSVII 
was negative.   How can I distinguish between HSV1 on 
my lips and genitals?  

Fast forward two years to current...I recently had sexual 
contact with a condom and during sex I began to get irritated 
in my genital area due to the rough contact.   The next day I 
had some redness and irritation that lasted for 2 days and 
went away...no blisters, no swelling, and a little itching.    
I guess my main question is would a Herpes genital infection 
be very similar to the infections I have on my lips and should 
I be concerned about this latest irritation two years later?   
What testing can I do to make sure that I do not have genital 
herpes once and for all and how would I be able to separate 
between HSV1 on my lips (which I would be positive for on 
a blood test due to my oral cold sores) and HSV1 on my 
genitals?    Sorry for the novel, I appreciate your expert 
opinion.
MJ

Dr Rob's reply...

Dear MJ:
A quite long question, but a simple answer:  you can`t.  
Oral Herpes or HSV1 is, in fact, the cause of lesions in 
20% of genital herpes so that the lesions can occur either 
place.  The difference is that Type 1 typically occurs in the 
oral area and Type 2 typically occurs in the genital area, but 
there is at least a 20% over lap.  I would repeat the Herpes 
Select Test that you had, as that will answer your question. 
[414 ]

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Question...


Is it true that if you already have the herpes 1 virus 
that you are not likely to get the herpes 2 virus? 

Dr Rob's reply...

Dear Poster Asking about Herpes Type 1 and 2:

Herpes 1 and Herpes 2 are two distinct viruses.  Getting one 
does not preclude getting the other.  Most Herpes Type 1 is 
transmitted orally. Most Herpes Type 2 is transmitted sexually.  
But the fact is, 20% of genital herpes is transmitted orally and 
20% of oral herpes is transmitted genitally. 
[413 ]

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Question...


I have a question in relation to the Immunoglobulin value 
in a person infected with herpes simplex virus. Please 
explain IgM and IgG.
 

Dr Rob's reply...

Dear Poster Who Asks about IgG and IgM: 

Initially the antibody that appears is IgM.  It is non-specific 
but it occurs very rapidly. The more specific antibody 
and the one that will control infections is the IgG antibody 
and that appears later.  As a result during the initial outbreak, 
one would expect IgM and over time the IgM would be 
replaced by IgG.  Were you to contract a second dose of 
herpes, it would be IgG not IgM that would increase.   
[412 ]

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