How Is HSV1 Transmitted?

Posted on Thu, 20 Mar 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 20 Mar 2014 Answered on

Mon, 14 Apr 2014 Last reviewed on

Question : I have been in communication with Dr. XXXXXXX Chail but cannot seem to contact him. Here is my question: I have had two positive HSV1 positive blood tests. My brother has common variable auto immune deficiency syndrome. He is currently have a very difficult time with iron deficiency anemia, infections and general ill health. He may have to have a bone marrow transplant. He has just had an endoscopy. They found ulcers in the esophagus attributed to a virus. The MD's have sent tissue samples for analysis. The results have not as yet returned. But, they have started him on an anti-viral medication. I think it is Zovimax which I think is used to treat HSV1. I am very upset because I feel that I may have given him the HSV1. I have been very careful not to touch him or be too close to him. Are only physical contact has been to shake hands. How great a chance is it that I transmitted HSV1 given his compromised immune system ? I would appreciate solid advice because it has terrific implications. One note that you should know that at the time it was discovered about 2 1/2 years ago that I have HSV1 I had unprotected oral sex from a sex worker. My doctors said that to say anything to my wife and family about the oral sex and HSV1. So, no one in my family knows about it. It's all very perplexing to me. Thanks for your help

Answered by Dr. Vivek Chail (5 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in to us and accepting my earlier replies. This is Dr.Vivek Chail and I am glad to be answering your queries ance again. The ulcers in the esophagus which your brother has is most likely Herpes esophagitis and that may be the reason the doctors have started ZORIMAX (Acyclovir). Acyclovir is given to treat Herpes infections. Please note ZOVIMAX is the name of a different medication ?Amoxicillin (antibiotic) marketed in some countries. Common variable auto immune deficiency (CVID) is a condition which may have a number of manifestations. Evidence of active human herpes virus 8 (HHV8) infection can be found in the peripheral blood monocytes of a high proportion of individuals with CVID with granulomatous and interstitial lung disease, consistent with the association of HHV8 with lymphoproliferative phenomena in persons with secondary immunodeficiencies and hematologic malignancies. You may not be the source of infection and please do not get upset over it. Your brother's condition is such that his immune system can get infected by herpes from any source in the society and not you alone. This might have happened months to years back and not exactly as you are thinking. Hope I have been able to answer your query. Do write back if you have any doubts. Regards, Dr.Vivek Chail

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

Follow up: Dr. Vivek Chail (2 hours later)

Thanks for your response, Dr. Your words are reassuring. But, as you can imagine, I am upset because I have HSV1 and have been in contact with my brother. I am concerned because I have been near him and shook hands with him particularly during his recent problems. Perhaps, I should not visit him because I don't want to cause another infection. I also don't know the reaction of his family and my family if his MD's ask if anyone in the family has herpes. I am very worried about it all, and pondering what will happen and what I should do. I would appreciate any advice at this point. Thanks.

Answered by Dr. Vivek Chail (7 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. Its important to know that HSV1 can be transmitted virtually from any person through mild skin contact. At age 75 years, it is possible that he was infect through a source other than you. Given his illness, it is advisable to maintain hygiene and cleanliness. This does not mean you dont visit him but you may take precautions like wearing a mask and clean hands so that you do not transmit any infection to him. It is least likely that any MD will ask for family history of HSV1 because it can be transmitted virtually through any person and not necessarily a family member. Please do not worry about this. You may maintain your privacy and confidentiality. It is possible that you too were infected with HSV1 much before receiving the oral sex recently. So with so many possibilities you please do not fear about having to speak in detail about your oral sex experience to anyone. 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 (2 days later)

Hi Dr. XXXXXXX - I need some advice concerning myself. For approximately the last month I have been having soft tannish stools quite frequently. I have taken Metamucil that helped somewhat. In the last two weeks I have gradually developed a lot of foul-smelling flatulence as well as stools. At the same time, I have developed a pain originating around my sternum and radiating both left and right in my chest. I get the pain when I swallow food. I am also feeling fatigued and very sleepy. I have tried using an ant-acid to relieve some of the belching and heart-burn. It has helped with the belching and heart-burn but not with the pain. Do you have any idea of what this might be ? Thanks.

Answered by Dr. Vivek Chail (20 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. It might be that taking Metamucil (laxative) is causing you the discomfort and also fatigue. It has been seen in some patients taking it. I would suggest that you discontinue taking Metamucil for sometime and observe yourself. Please take in fiber rich diet for a while and also drink lots of water through the day. 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