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Do I Have Reveal My HSV1 Positive Findings For Bone Marrow Transplant Donation?

Posted on Mon, 24 Mar 2014

Question: I have a difficult problem. 2 years ago I had unprotected blow job by a sex worker. Shortly thereafter, I had fever and not feeling well for a few months. I had an STD blood panel done. It came back positive to HSV1. All others were negative. I have been rather well ever since. Recently, my brother was told he may have to have a bone marrow transplant. His MD's said that they may want me as a donor. I believe that I have to go through screening. My question is do I have to reveal my HSV1 positive finding? If so, can the MD's keep the information in confidence. I ask this because my primary and urologist advised me not to tell my wife and family about the sexual encounter and positive HSV1 result. My primary is on medical leave. So, I can't speak with him. I would not like, at this point, to have the bone marrow MD's to inform my brother and family as well as my family about my HSV1 result. I do want to help my brother and would appreciate your best advice

Answered by Dr. Vivek Chail (1 hour later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi, Thanks for writing in to us. I have read through your query. HSV1 can be contracted from many sources and not only receiving oral sex. It is important however to take your brother's MDs into confidence and inform them of your possible HSV1 infection status. You may get a repeat HSV1 test done to know your present antibody status. You need not tell the other doctors about your oral sex incident. Your HSV1 status should be kept confidential and if you are found unsuitable for donating bone marrow then you can tell your family that the match is incompatible instead of giving details. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (1 hour later)

Thank you Dr. Chail, I have a follow-up question. When I disclose the HSV1 positive test results to my brother's md's, do they have an obligation to tell him in order to prevent any passing of the HSV on to him by me in the ordinary course of daily living? In addition, I have read that since I am 75 years of age and have sleep apnea that I am not eligible to be a donor. Is this true? Lastly, I was retested for HSV1 about 1 month ago. Quest Diagnostics blood specific test was 5,000. Previous test (2 years ago) was Lab Corp blood specific test was 4,500. Is there any significance in these results ? If you can think of any other info I should have, please let me know. Thank you for your time, patience and advice.

Answered by Dr. Vivek Chail (3 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX, Thanks for writing back with an update. Your age at 75 years is truly a concern regarding the suitability of being a healthy donor for your brother. This is the first step in deciding if you are allowed to donate bone marrow to your brother. Then comes the part where it is not mandatory to reveal any kind of personal information other than the fact that tests have shown you to be HSV1 infected. HSV1. Herpes simplex virus infection is extremely common in the United States with a seroprevalence of 58% for HSV-1. So please do not worry as HSV1 can be transmitted through close contact which necessarily need not include sexual practices. Any other information that you should have may include that sexually transmitted infections can also be transmitted by close skin contact and not always be penetrative or oral unprotected sex. So please get tested if desired and do not receive or provide sexual pleasure from complete strangers. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (8 hours later)

Thanks, Dr. You wrote: " So please do not worry as HSV1 can be transmitted through close contact which necessarily need not include sexual practices." I don't quite know what this means. I assume that close contact excluding sex is a way to transmit HSV1. I have a concern about my granddaughters. If I kiss them on the cheek - is this considered close contact? Also, if I am approved to be a donor for my brother, are his doctors obligated to tell him that I have HSV1? My concern is that my doctors advised me not to tell my wife and family about the HSV1. I believe that I have to have an agreement with the donor doctors that they will know but not reveal my HSV1. Is that reasonable? I know I am asking you a lot. But my primary MD is out on medical leave and I have no way of contacting him. You have been a lifesaver in helping me. Thank you.

Answered by Dr. Vivek Chail (34 minutes later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXXX, Thanks for writing back with an update. HSV1 is oral herpes but can affect any part including inside the mouth and genital areas. It is spread through non sexual means which includes kissing and rubbing of skin with an infected person. This disease remains dormant for long periods of time and symptoms appear only when reactivation takes place due to immune reactions. You will be approved to be a donor only when your results are negative for the common infections including HSV1. His doctors are not obligated to reveal complete information regarding your HSV1 infection status if you request it not to be shared. Complete privacy must be assured to you. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar