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Ask An Expert

Herpes Simplex 1 and Kissing

Jane Varner

Jane Varner, M.D.

Palo Alto Medical Foundation

Question:

I have recently been diagnosed with herpes simplex virus 1. Does that mean I will never be able to kiss?

Answer:

Let's begin with a quick review of how our immune system works. When your body recognizes an invader, such as a virus, it quickly manufactures fighter cells — also known as antibodies — to that invader. Once the invader is conquered, most of those antibodies become inactive, but a few hang around…just in case! Most blood tests used to look for viruses are actually looking to detect the presence of antibodies to that virus.

So you “tested positive” for Herpes Simplex Type 1, or HSV-1. That means that there was a detectable level of antibody to HSV-1 in your blood stream. It could be a recent exposure, or a really old exposure — there is no way of telling.

HSV-1 is a very common infection; worldwide, more than 90 percent of people will test positive for the virus. Once you have the virus, it never leaves your body — it just goes to sleep in a nerve ending and “wakes up” when your defenses are down, like when you are exhausted, stressed out, sick, etc. When the virus wakes up, it can express itself in many ways such as blisters in your mouth, on your lip, in your eye, and even sometimes on your genitals.

We know that contact with active herpes lesions or oral secretions (like saliva) can lead to HSV-1 transmission to another person. In fact, studies have shown that up to 9 percent of adults have detectable HSV-1 particles in their saliva, even with no symptoms at all. However, the viral titer is 1,000 times higher in fluid obtained from actual HSV-1 lesions. As a result, transmission is MUCH more likely to happen when someone has active symptoms.

So, can you ever kiss again? I vote yes, although there is a slight chance of transmitting the virus even in the absence of any symptoms. To reduce the likelihood of transmission, if you DO have an active HSV-1 lesion (like a lip blister), skip the kiss…and give a hug!

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