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Hello,
I am a 34 year old male. About 5.5 years ago i noticed a very mild irritation on the top side of the shaft of my penis, just below the head. It did not itch or hurt or feel like much of anything, it was just visible. The doctor examined me and suspected it was just an irritation and that it did not look like herpes to him. I insisted on getting tested just to be sure and blood test came up positive for hsv1 and hsv2. I am not aware of what specific type of test was run or the specific results, only that it was positive for antibodies. He also did a swab of the area but there was zero liquid to be swabbed, and that test came up empty. I was not sure what to make of that result, but internalized that i may have at some point been exposed to the virus, but that irritation that day was not herpes. I was not prescibed, nor did i take any medication. So I moved on.5.5 years have passed with zero symptoms of herpes, until last week. I should mention that i had several female partners since age 16 with sporadic condom use, maybe 50/50. I woke up in bed and started masterbating, and i felt an odd sensation, sort of like i was both masturbating and scratching an itch. However when i stopped there was no itchiness. I went to inspect an noticed a small elevated puffy red patch in a similar spot to the area 5.5 years ago. It didnt itch or hurt or feel like anyThing but was noticeable visually. The next day i inspected again and it was still there, but perhaps a bit lighter than the day before with still zero sensation. I went to a different doctor this time who said he wasnt sure what it is (and he has seen many herpes cases), but that herpes was possible, although it would be a very atypical case. When i told him about the experience 5.5 years ago, that swayed him to think that we were probably dealing with herpes, perhaps type 1 on genitals. He prescribed valtrex and i started taking it that day. Each following day the spot got lighter and lighter. By day 4 it was totslly gone. There was never any itching, pain, or secretions. In that time after the doctor visit i noticed a second spot in the corner of my mouth that looked like herpes also, but again very mild. This indicated to me that i was probably experiencing type 1. This spot also went away in a about 4 days with no pain or secretion.
My initial question is that since my symptoms appear very mild, am i at less risk of transmitting than someone who has more severe outbreaks? What i experienced both times was no more offputting than a zit. I can live with that every 6 years. My primary concern is being a walking virus shedder. Do i perhaps have a mild version of the virus that sheds less and only sheds the same mild version? Help!!
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First of all, I would be interested in knowing more about the diagnostic testing used. We now know that in the type specific antibody testing there is a range we describe as low positive where there are many false positives. In the range of 1.1 to 3.5, half of those are false positives (people really don’t have herpes). Since you have had so few symptoms over the years, I think another antibody test might be very useful. Or at least get a copy of your original test to check on the values and be certain it was an IgG test that was type specific.
If you do actually have herpes, the person who is asymptomatic (or rarely symptomatic) does shed fewer days than the person who has many outbreaks, yes, but you cannot know when those days are, unfortunately.
Terri
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I can’t really tell much from this picture.
Yes, it is possible if you are truly infected with HSV 2 that this is all you will get. People vary widely in their symptoms with HSV 2, some very mild and some not mild at all. And that can change over time, too. It likely has to do with with an individuals’ immune response rather than something about the virus itself. Please save your next question for when you get your results back and we can talk more intelligently then, OK? Or if you want to ask more questions now you certainly can.Terri
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You are certainly not alone in not having dramatic symptoms with herpes. Eighty percent of those infected with HSV 2 don’t recognize their infection so it is likely that most people do not have dramatic symptoms. I do believe that the areas on your penis that are irregular for you are HSV. Possibly you had HSV 1 first and that immune response keeps HSV 2 outbreaks minimal for many people. Also, you should know that you can have outbreaks anywhere in the area covered by a pair of boxer shorts, so keep an eye out in that whole area. The average person with herpes sheds about 13-14% of days (so 13 or 14 our of 100 days). With daily antiviral therapy, that number is reduced by about half. We cannot know for any individual person how much they shed without daily home swabbing. We believe strongly that everyone with HSV 2 sheds virus at some time or other. And yes, I feel strongly that future partners should be notified prior to sex.
I don’t think we are close to a vaccine at this time.
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Terri
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The 13-14% is an average. More specifically, on one study we published in JAMA of 2011, virus was detected on 20% of days for symptomatic people and 10% of days in asymptomatic people. You seem interested in pursuing the exact numbers a bit more so I would refer you to that paper You can find it on PubMed first author Tronstein, and I am also an author on that paper.
If you are asymptomatic, use condoms, take daily antiviral therapy, and disclose your herpes status to your partner, your risk of infecting that person is low. I do not know what the exact risk of having unprotected sex on the shedding day is. We do not have that data. Certainly if you use a condom the risk is reduced somewhat.
Terri
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