Deep HSV questions

[Jliv4]

Hi Terri, I Have some questions that aren’t clear to me.

I am a gay male. I found out I had HSV1&2 when I was 19 due to being a hypochondriac, because I performed oral on someone who had pearly penile papules. I am now 26 and haven’t had my first oral outbreak until 22 or 23, which comes once a year. I still have not had an outbreak genitally unless you coun ingrown hairs, or chafing. I also took about 5 tests because I’m genitally asymptomatic.

1. Is it worth to take the Western blot test?
My igg has been:
During oral cold sore
Hsv1:50.80
HSV2: 2.14

After oral cold sore has healed
HSV2: 1.93

This is all last year in the summer, any prior tests didn’t give me igg.

2. There are no studies on MSM except for one 2002 or 3 study unfortunately, which believed more than 50% of MSM has hsv2. Do you believe this has increased due to the nature of men and sex and because it is not monitored like HIV which has decreased over the years? I guess I’m asking what do you think the percentage of MSM has hsv2 now?

3. Due to there only being studies for hetero,
What do you think the transmission risk is for MSM topping, bottoming with no protection, with Valtrex only, with condom only, and all 3? I know you may extrapolate those numbers, but since the numbers are different fo male-female and female-male, wouldn’t male-male percentage be completely different since no female anatomy involved?

4. It is not a legal thing to disclose, but more ethical. I have been told first by my old doctor to disclose and have always thought it was mandatory, including peer pressure saying yes you have to. I know Most people don’t disclose OHSV1 due to its prevalence, but hsv2 is still somewhat common. If I have never broken out genitally do you think it’s worth disclosing, and what are the chances of transmission in all scenarios of protection/none?

5. Is it worth disclosing to casual partners rather than relationships? What’s transmission rates for both?

Thank you for your time.

5.

[Terri Warren]

With your low index value, you need a confirmatory test, absolutely. There is a good chance you don’t have HSV 2.
We don’t have data on transmission of HSV 2 in gay men, and especially if it is oral only.
I would say bottoming with no condom and no antiviral medicine is the highest risk. Add Valtrex and the risk is reduced by 48%, add condoms and the risk is reduced by 96%.
But before worrying about that, get a confirmatory test! Have your other IgG numbers been very different?

Terri

[Jliv4]

Hi Terri,

I took the western blot test a few months ago and got a negative result for HSV2 cant remember if i tested for HSV1 but that’s been high so I know I have that.

Going forward I’ve been wanting to avoid any blood tests with herpes unless I received symptoms which has been going well until I have been getting small red bumps on my penis glands. It started after having sex without any lube or condom which cause and irritation if 2-3 small bumps on the head that last 8 days until I put aquaphor on it. Then a couple days after I had sex and unde the head the shaft was slightly inflamed due to it being red ish and but that has since been less red. I had oral and a day or 2 later I notice 2 more small bumps showed up close 2 each other, but not touching and which grow and shrink depending on time of day, which I have stopped using aquaphor in case it’s due to heat. I do have dermatitis but it has not been on my penis but I have heat bumps all over my hands right now due to change of season, and my doc says it’s not uti. And has order a full panel of sti, but doesn’t think its herpes.
1. Knowing that getting blood work from herpes will give back a positive but low positive based on my index in ghe first post and after the WB giving negative, how high on a blood test should we be worried if it’s possibly an actual positive that would need another WB confirmation in this upcoming test?

2. Should I get future genital herpes tests if I have a skin reaction down there or to avoid any tests unless the doctor think it’s that regardless of my anxiety and hypochondria?

3. Ever since I was diagnosed negative on the WB it has been a relief for me due to the burden lifted on having to disclose, but still stand that it is stigmatized, but I have realized it had damaged me with me thinking for years I had it of false diagnosis, hence the anxiety. Do you have any advice? Know of any research for cure or destigamtizing blogs?
Feel free to share any extra information beyond.

[Jliv4]

Continued…
I just received my results, it was negative for everything except hsv1&2.
HSV-1: 44.90
HSV-2: 2.21
My previous values are in tge first thread. I Have not had a cold sore outbreak yet but this is usually when I do get them, maybe that’s why it’s so high.
I received a negative on the western blot for HSV-2, but this current blood test at 2.21 is the highest from when it was 2.14 during my last oral outbreak, and 1.93 after tgat oral outbreak. Should thos be of concern or I am still negative and number fluctuate even if truly negative.
If so, at what value should I question my status of having hsv2 since western blot says negative? Just in case I ever get tested again in the future other than and actual outbreak.

Based on last thread, I explained the bump on penis from friction, well with awuaphor it went down and isn’t red but I still think it’s there and soon after the lighter part of shaft below the head became inflamed and I receive 2-3 more bumps not touching each other but very close in a straight line with one of them when it went down it created a circle like when your skin is peeling, that soon healed and the 2-3 bumps in a line is still present and red, my doc gave me fungal cream just in case, but mycoplasma and sti test were negative. Although on my hand I have a lot of small bumps that didn’t hurt and appeared I believe last week or 1.5 weeks, now it tingles, and realized yesterday I all over my arms, thighs, knees, ankles, foot and tingles alot, I’ve had this year’s ago but with everything except it possibly happening on my penis it was on my buttocks and I used to scratch alot which made unbearable amd it filled with fluid and very sensitive to heat,cortisone barely helped. What do you think this could be?
Also, I do have dermatitis and every year occasionally get cold sores on lips, bumps all over front and back of hand at random, and skin patches, and dark patch on thighs, arms and even on my lip that lasts weeks but don’t hurt.

[Terri Warren]

I don’t know what could be happening with your hand but if you are concerned, you should have a medical professional check it out.
Your index value is still in the low positive range. It has been my experience that people who have low positives values (those below 3.5) continue to have those as they test beyond a negative western blot. I can’t promise you that this is a false positive result again, but I think it is likely.

1. Knowing that getting blood work from herpes will give back a positive but low positive based on my index in ghe first post and after the WB giving negative, how high on a blood test should we be worried if it’s possibly an actual positive that would need another WB confirmation in this upcoming test?
I would be concerned about anything over 3

2. Should I get future genital herpes tests if I have a skin reaction down there or to avoid any tests unless the doctor think it’s that regardless of my anxiety and hypochondria?
If you have an actual sore or sores in the genital area, they should be swab tested, yes

3. Ever since I was diagnosed negative on the WB it has been a relief for me due to the burden lifted on having to disclose, but still stand that it is stigmatized, but I have realized it had damaged me with me thinking for years I had it of false diagnosis, hence the anxiety. Do you have any advice? Know of any research for cure or destigamtizing blogs?
Feel free to share any extra information beyond.
There is a Reddit thread that is very helpful identify the most recent work on cure and treatment.
I know it is sometimes hard to get past the belief that you were infected and when you are not. You just have to keep working on that in your head.

Terri

• This reply was modified 10 months ago by Terri Warren.

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