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What are the chances of HSV 1 transmission through protected intercourse?

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Posted on Mon, 1 Jun 2015
Question: Hi - gathering second opinion; from specialist.
I had protected intercourse with someone who afterwards informed me she was positive for HVS1, asymptomatic. I am now very concerned about the dots/marks that appear right above my circumcision scar. This encounter 8 days ago, I am awaiting IGG results. This area of my penis has been tender / sensitive to touch for 4 days now. I am concerned about possible transmission of HSV1 genitally. I uploaded photos. Can you offer opinion please.

I've read to many things on the internet regarding possible transmission of HSV; even with protection, no oral sex and no visible sores (asymptomatic). What is the likelihood of this; and how quickly would I expect to see evidence if it appears, regarding the prodrome period, and after if I have acquired the virus? Does HSV1 look same on genitals as a cold sore, etc? Thank for your time and candor.
doctor
Answered by Dr. Dr. Kakkar (2 hours later)
Brief Answer:
Kindly upload an Image again

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have understood your concern.

Unfortunately I have not yet received the Images. You may try and upload again.

Hsv type 1 usually cause oro-labial herpes but it can cause genital herpes.
Even if you were infected it is too early (just 8 days) for circulating antibodies to appear and therefore for IgG results to become positive.
Hence this test is not relevant at this stage for this particular exposure.

Hsv is usually transmitted by close/ direct contact with an infected sexual partner.
A condom does not provide 100% protection because it leaves a lot of area exposed for direct contact during sexual intercourse i.e pubic area, base of shaft of penis.
However, it is unlikely that you would have got genital herpes on glans Or on shaft above circumcision scar because that area would usually be covered with a condom during sexual encounter.

Incubation period of genital herpes varies from 2-12 days. Average incubation period is 4 days.

Genital Hsv usually presents with either grouped, fluid filled vesicles like a cold sore Or genital erosions which may have a painful, burning sensation.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (18 minutes later)
Hi - Thank you, I have uploaded the pictures. My primary concern is her being positive for HSV1 and the possibility of catching it even if she is asymptomatic, and if her infection area is genitals, the likelihood of catching it with a condom. I wasn't sure if the exposure was somewhere else in the pelvic region, if my initial outbreak would still appear of the saft, head of penis?
doctor
Answered by Dr. Dr. Kakkar (2 hours later)
Brief Answer:
Upload Images as directed

Detailed Answer:
Hi.

I have still not received the Images.

You can upload Images either at "Reports Section"

Or

You may also mail me the Images at YYYY@YYYY
Kindly mention the subject of this mail as Attn:Dr. kakkar.

Herpes can transmit even during clinically asymptomatic phases, however with less likelihood.
If you happened to acquire herpes infection through this particular protected sexual encounter the initial episode would occur at the site of contact/ acquisition i.e base of shaft and pubic region, however, subsequent recurrences can involve the glans and adjacent shaft as well i.e the infection can spread to other neighboring areas.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (4 hours later)
Uploaded images again.
doctor
Answered by Dr. Dr. Kakkar (9 hours later)
Brief Answer:
Not genital herpes

Detailed Answer:
Hi.

I have reviewed the Image.
No, this is not genital herpes. There are no erosions/ ulcers suggestive of genital herpes.
These most likely looks like prominent sebaceous glands more than anything else.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (6 hours later)
Thank you for the response; I uploaded an additional photo that is more detailed with the papules I am concerned about. They are slightly raised but not blisters.
doctor
Answered by Dr. Dr. Kakkar (8 minutes later)
Brief Answer:
Possibility of Molluscum contagiosum

Detailed Answer:
Hi.

I have reviewed the Image.
These seem like lesions of Molluscum contagiosum. It is a viral infection and usually presents as asymptomatic, dome shaped papules. There might be a central umbilication/ pit on close examination.
Molluscum contagiosum is also an STD.
Treatment is simple i.e either with Co 2 Laser vaporization Or with Electrocautery ablation.

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

Dermatologist

Practicing since :2002

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What are the chances of HSV 1 transmission through protected intercourse?

Brief Answer: Kindly upload an Image again Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have understood your concern. Unfortunately I have not yet received the Images. You may try and upload again. Hsv type 1 usually cause oro-labial herpes but it can cause genital herpes. Even if you were infected it is too early (just 8 days) for circulating antibodies to appear and therefore for IgG results to become positive. Hence this test is not relevant at this stage for this particular exposure. Hsv is usually transmitted by close/ direct contact with an infected sexual partner. A condom does not provide 100% protection because it leaves a lot of area exposed for direct contact during sexual intercourse i.e pubic area, base of shaft of penis. However, it is unlikely that you would have got genital herpes on glans Or on shaft above circumcision scar because that area would usually be covered with a condom during sexual encounter. Incubation period of genital herpes varies from 2-12 days. Average incubation period is 4 days. Genital Hsv usually presents with either grouped, fluid filled vesicles like a cold sore Or genital erosions which may have a painful, burning sensation. Regards