HSV-1/HSV-2

[anxiety10]

Terri,
I wasn’t sure what I needed to do create a new question or post on my original “4 Negative Tests”. Anyways I have a question about HSV-1 which I had since I was 18. I was always told they were cold sores and they were contagious when the sore are present no kissing. From that time I can’t recall having cold sores until Nov 2014 when I was stressing out about having HSV-2. I got them May 2015 and again Tuesday 7/28/15 I woke up and noticed a red bump on my lip I already knew it was coming from that moment on.
My problem is I gave my boyfriend oral sex on Saturday 7/25 maybe 5 minutes at most (I didn’t feel anything going on with my lips) now I’m worried about transmission. I was at the gynecologist on Tuesday and I was able to ask her about it she says it’s contagious when you feel the tingle (which I did only on Tuesday) until it is completely healed. She gave me a Rx for valacyclovir which helped greatly and she said that’s all I need……. use it at the first tingle. My old gynecologist told me I would be infectious when sores are present but never mentioned medication my primary laughed when I told him Planned Parenthood told me I needed medication for HSV-1. When I was with my ex-boyfriend (about 8-9 yrs) I never had an outbreak and gave him oral plenty of times ( I’ve never seen him with cold sores) . Should I be on medication for HSV-1? So that’s my dilemma about HSV-1

Now about HSV-2 I know we spoke about this already but please just answer my questions.
The tingling I have an idea of what it is…….. piriformis syndrome I got my first treatment yesterday and it helped a lot. I go back next week for more treatment.

I wish I could put all of this behind me given my test results but it’s hard when there’s some sort of symptoms still going on and can’t quite be explained yet (except for the tingling). Along with the time frame when the symptoms (throbbing,irritation of the vagina) first appeared 11 days after exposure to HSV-2. I’m trying to put of this behind me I know 3 of the gynecologist (from the office where I’m no longer welcomed) the new gynecologist and you, the herpes expert, have told me believe your results NO more testing! My rational side wants to but like I said it’s just the unexplained that keeps me from doing so. I’m also going to see a psychologist for my anxiety. I can’t live like this anymore
Here’s my questions:

1) What exactly is ELISA/BIOKIT? What’s my test considered? The IgG test I’ve done 4xs

2) If there’s no lesion would PCR be of any use? The old gynecologist performed it 2x 6/9/15 and 7/7/15 both times came back negative for HSV-1/HSV2-2

3) If after all attempts have failed to try to pin point my vaginal issues do you think I should retest on Oct 17,2015 which will mark a year for the incident ( I think i know the answer but still have to ask)

4) In all your 33 years have you ever seen anyone test positive after 4 IgG negative tests after a year? No other tests done (where one was positive one was negative) No herpes medication taken at any time before tests were performed

5) Does stress really have an effect on the vagina? I’ve gotten that from the gynos

Thank you

[Terri Warren]

The IgG is an ELISA yes,
I don’t think further HSV 2 PCR swabbing would be useful, no
No, I don’t think another test at a year would be helpful. Have you done a western blot?
I have not seen anyone test positive at a year that did not take herpes medicine and has previous negative IgG tests.
I’m not sure about stress and the vagina honestly. I doubt that it by itself would cause the symptoms that you describe but I can’t say 100% on this.

HSV 1 can be transmitted even when no symptoms are present If you boyfriend actually test negative for HSV 1, then it is reasonable to consider suppression for yourself. that’s a decision to be made between the two of you.

Terri

[anxiety10]

Thanks for the response Terri

What would the transmission rate on 5 minute oral ? Now I’m worrying about that!! It’s been 8 days today and he hasn’t mentioned anything. I will get medication I don’t want this type of scare.

No I haven’t taken the Western Blot. Should I ? What’s the likely hood of the Western Blot coming back positive? Or will it confirm the NEGATIVE status? What do I need to do to get the Western Blot?

[Terri Warren]

Do you actually know if your partner has HSV 1 infection or not, via an antibody test? If you don’t actually know it might be worth him testing to put your mind at rest or be aware that suppression is a consideration to reduce the risk of transmission.

I think it is really unlikely that your HSV 2 western blot would be positive. If you are negative, the western blot would confirm your negative status, yes. Our clinic can order a western blot for you to be drawn at a lab near you.

Terri

[anxiety10]

So I went to my gynecologist and she doesn’t think I need to be on suppressive medication. Ugh! And as I stated before my primary laughed when I mentioned that Planned Parenthood (over the automated system said I should get medication for HSV-1) and all the other gynecologists never mentioned medication just not to kiss or engage in oral sex with an outbreak. My boyfriend and I spoke about cold sores before he said he never got them just canker sores ( which I know are different). And prior to this I was unaware just how bad cold sores could be like I’ve said I haven’t had them in years until all this stress ( which I brought upon myself)
Today is day 12 since oral and nothing yet. I’ve tried so hard to be careful after the whole HSV-2 and now to think I might give him HSV-1 it’s killing me!! Why do some doctors make it sound like it’s no big deal? One of my gynecologist told me I didn’t have tell anyone just don’t kiss or perform oral when there are sores present

How does one know when they are shedding?

I’m thinking about doing the Western Blot just to close the HSV-2 chapter it’s just going to be the waiting part that’s going to get me since it won’t be like the IgG (which is comes back at a week at most)

• This reply was modified 8 years, 1 month ago by anxiety10.

[Terri Warren]

My position on this is if your partner tests negative for HSV 1 and you now you have cold sores, then taking medicine every day to reduce the risk of infection him is a completely reasonable thing to do. You need to figure out what you want to do and find someone who can help you with that or let it go.

There is no way to know for sure when you are shedding virus, no.

We can help you with the western blot order if you would at least like to close the HSV 2 chapter

Terri

[anxiety10]

I was able to get an Rx for Valtrex for my oral HSV-1 so that’s a relief! I haven’t taken it yet because I would like to do a Western Blot. My new ObGyn office says they can order any test I wish, we shall see if that’s true . I do have some more questions though I prefer to ask you because of the variety of answers I have received from other professionals.

1) Since I have HSV-1 orally (well established) is it unlikely I can acquire it genitally?
The last ObGyn told me since my antibody (HSV-1) was high it could be that I have it orally and genitally since HSV-1 is interchangeable.

2)The IgG test misses 25% of HSV-1 and will continue do so. Why? And does that occur with HSV-2 as well?

3) Is it true HSV-2 can be mistaken for HSV-1? How?

[Terri Warren]

1) Since I have HSV-1 orally (well established) is it unlikely I can acquire it genitally?
The last ObGyn told me since my antibody (HSV-1) was high it could be that I have it orally and genitally since HSV-1 is interchangeable.

The answer to this depends upon when you first acquired HSV 1. If you have had cold sores since childhood (which I don’t think is true for you) or before you were sexually active in any way, then your cold sores were not acquired in a sexual way. If you were kissed and got cold sores from that but did not have sex or received oral sex, then the antibody you developed from having a cold sores would protect you against genital HSV 1 infection. However, if you didn’t get cold sores until you were sexually active (more specifically received oral sex), then it is possible that you acquired HSV 1 both orally and genitally at the same time.

2) The IgG test misses 25% of HSV-1 and will continue do so. Why? And does that occur with HSV-2 as well?

It’s a fault of the test – for some reason, it is just not sensitive enough to pick up a lot of HSV 1 infections. The same is NOT true for HSV 2 infection – it picks up 97-98% of HSV 2 infections (this is all compared to western blot, the gold standard)

3) Is it true HSV-2 can be mistaken for HSV-1? How?

I’m not sure what you mean by this question. A type specific swab test could tell the difference between HSV 1 and HSV 2 as could a type specific antibody test. Both lesions look alike, exactly. perhaps you are wondering if a clinician might tell someone they have HSV 2, because they erroneously think all genital lesions as HSV 2 and all oral lesions are HSV 1. That’s a possibility, I suppose.

I would be very surprised if your doctor can order a western blot but maybe. I guess you will find out.

You have five posts remaining on your subscription.

Terri

• This reply was modified 8 years, 1 month ago by Terri Warren.

[anxiety10]

Thanks for the quick response!

I’m not sure how I got cold sores I do know I got them long before being sexually active.
What I meant about HSV-2 being mistaken for hsv-1 was by the blood test I forgot where I read about it.
I will contact your office if the ObGyn office is incorrect about the Western Blot. Quick question though does insurance cover the WB ordered by your office?

[Terri Warren]

Insurance does not cover western blots ordered through our clinic, no.
You might have read that people who have HSV 1 already and then test for HSV 2 may have a false positive on their HSV 2 , due to their pre-existing HSV 1 infection. However, recent research has shown that is not true. Otherwise, I don’t know what you might have read.

Terri

[anxiety10]

So yes it’s true my obgyn office offers the Western Blot…….. the lab and I are playing phone tag for now. I was ready to actually call this whole HSV2 thing off. When I last posted I came back from the psychiatrist and talking to him really helped along with your post about the ELISA test sensitive and picking 97-98% infections. 9/2 I went to the obgyn for a new birth control prescription since the old office wouldn’t refill it. In that appointment she did a physical did a pelvic exam also used a speculum to check my cervix said everything looked good and healthy. We spoke a little more about the HSV2 negative results and she was adamant that I don’t need to retest. But if I do want to I can. She claimed IgG blood tests and PCR swabs don’t lie .Also on 8/25 I saw the dermatologist for an annual skin check and he did check my vaginal/anal region said he saw nothing. He said I need to move on and accept the negative tests. Plus I was feeling good no funny feelings down there I was ready because of all that and looking back I’ve seen 6 different obgyns who all say I’m negative. Not to mention the 4 IgG negative results countless pelvic exams and a ultrasound.

Now the game changer I came on the forum on 9/4 and saw that badtimeinmylife has tested POSITIVE on the WB after a year of NEGATIVE IgGs. Her story sounds a lot like mine so my whole outlook has changed again. I also see that on 9/9 sillybrain posted that they tested POSITIVE on a swab for GHSV1 when they already have an old oral HSV1 . I’m now freaking out about possibly having HSV1 genitally. I know these situations aren’t impossible but are less likely

1) I’ve had no lesions//splits whatsoever anywhere BUT
1 yeast infection in July after taking metronidazole for BV found on 6/14
it was my first one
2nd yeast infection 8/10 also due to metronidazole after a BV on 7/28
a bad one at that I had to do 2 diflucans and a week later terconazle was prescribed
And just yesterday I started experiencing some Yeast symptoms again no itching just a burning feeling on the outer lips and some in rectum it comes and goes Also kind of tingling feeling in my medial side of the thighs I’m back to checking constantly down there
I haven’t been taking any antibiotics so I don’t know why I would have a yeast infection yet again I did read stress and lack of sleep (which I am definitely experiencing) can cause yeast but that’s a long shot I think
I’ve read herpes can be mistaken for yeast infections so maybe these are my outbreaks? And how can the PCR swabs work if there was no lesions to test? The obgyn said they are very sensitive and will pick up the infection
I’m not taking the valtrex (for my oral HSV1 which is pretty old and didn’t acquire sexually probably from kissing 1 of the 3 guys I’ve kissed way back ) yet because I don’t want it to interfere with the WB
I feel like a walking infectious disease I just want this to end already it’s going to be a year soon

[Terri Warren]

Remember that the person who tested positive on western blot had NOT tested negative on western blot for a year, she had tested negative on the screening IgG test. Let’s not confuse the two. Yes, I know that sillybrain tested positive on a PCR swab after having cold sores and I know that is going to freak a lot of people out. So this makes two in 33 years. So it can happen but that doesn’t make it likely, does it?
Your Valtrex is not going to mess up the western blot at this point. I’m happy you are able to get the western blot from your doctor’s office, that’s great.

Terri

[anxiety10]

Ok the office was incorrect they offer the WB for HIV not herpes. What do I need to do to get the WB through your office?
Yes, I know badtimeinmylife tested Negative on the IgGs not the WB. Maybe I didn’t word it right. It’s very scary to think I can too.
Questions:

1) How can herpes be mistaken for a yeast infection or bladder infection?

2) Why are almost all the obgyn’s just looking for sores? All have said there would be sores by now if I have HSV2

3) How can the ELISA keep missing HSV2? I thought it was better at picking up HSV2

[Terri Warren]

1. Yes, herpes can be mistaken for a UTI or yeast infection
2. Ha! You are asking me? I have no idea honestly. None. Lack of knowledge, I suppose.
3. It is better at picking up HSV 2 than HSV 1, yes. It misses 2-3 out of 100 for HSV 2.

You can just contact the clinic and let them know you want a western blot and they will set you up for a phone appointment with me and I’ll arrange it.

Terri

[anxiety10]

Terri

I have set up a phone consultation with you for the WB. I do have a few questions though. I’ve been taking Valtrex (for oral HSV1) for 9 days now (always at the same time)

1) If I had genital HSV2 the “symptoms” should have gone away or subside by now?

I’ve had a tiny little pimple on my medial L thigh and one my R butt cheek they went away in less than a day though so I’m not sure
Today I noticed a a pimple on my low back
I may just be freaking out since I’m back to being scared of possibly having HSV2 I’ve gone back to checking multiple times a day All the previous symptoms I have stated are still here

2) I’ve read on other posts where people tested positive for either or both HSV1/HSV2 but some of the values are 9 , 10, 20 why is that? My value for HSV1 oral is 56

[Terri Warren]

How long ago was the incident that caused you worry about HSV 2?
Some people have the Quest test and some the LabCorp. The LabCorp scores are always higher, different test.

Terri

• This reply was modified 8 years ago by Terri Warren.

[anxiety10]

It will be a year on 10/17. I’ve had no “OB” nothing just discomfort for pretty much every month with the exception of February/April/May I’ve been feeling somewhat normal down there( before I started to take Valtrex) I’ve had 3 bacterial vaginosis and 1 UTI (urologist diagnosed it) I’ve never had any issues down there prior to the HSV2 encounter. 4 IgG negative tests last one was 8 months post exposure all done by LabCorp
With all the obsessive reading I’m just freaking out

1) HSV2 doesn’t always have the classical OB
Can be symptom less may never know until tested
Can be confused for yeast infection or UTI pimple/bug bite/jock itch

2) badtimeinmylife continually tested negative via IgG blood test for almost a year only when she did the WB did she come up positive

[Terri Warren]

Yes, it is true that a person can have HSV 2 with no symptoms or abnormal symptoms. And yes, she did do that. As I think I’ve said, the IgG test misses 2-3 per 100 that the western blot picks up.

Terri

[anxiety10]

Yes, you did say that. Given all those factors I have to do the WB for confirmation. I can’t go on living in constant distress. I want to move on already. I’m on daily medication for my anxiety though I think I need to up it because it’s not helping.

Herpes “pimples” wouldn’t clear up so quickly right? And it wouldn’t appear on the back?
At least with oral HSV1 I know what to look for and expect……… stress and sun are my factors.

Thank you

• This reply was modified 8 years ago by anxiety10.

[Terri Warren]

Right, they would not clear up so quickly. Let’s get this behind you OK? Do you have an appointment with me or are you going through UW?

Terri

[anxiety10]

I have an appointment with you.
I now know that the pimples I had one on my L thigh and one on my R buttock they were just pimples. I saw 2 on my shoulder……unless herpes travels that way too :/ .
I’m now on my 11th day of Valtrex (oralHSV1) so that should be preventing OB correct?
I have what I think is a post waxing bump which came on 4 days after waxing and 6 days on Valtrex. If it were to be herpes “ingrown” then it wouldn’t have a tiny hair coming out right? Looks/feels like a bump hasn’t gotten bigger it’s actually going away…. doesn’t look like a sore or have the characteristics of one and it doesn’t hurt
Is there any link between herpes and vulvadynia? I have not been diagnosed with vulvadynia but I’ve been researching my symptoms of vaginal discomfort

Thank You

• This reply was modified 8 years ago by anxiety10.

[Terri Warren]

No, herpes does not travel in this way. I would think 11 days of Valtrex would be very useful in dealing with HSV , yes
Yes, that does sound like what an ingrown hair looks like
The thing about vulvadynia is that it is pretty constant and herpes is not a constantly presenting disease, no. Herpes could could certainly cause pain with intercourse but that’s different, I think, than what we are discussing here.

Terri

[anxiety10]

My Western Blot came back NEGATIVE for HSV2!! I was extremely happy and was ready to move on but of course my crazy mind just won’t let me. Now I’m worried it may be HSV1 I have to worry about! I have HSV1 orally I don’t know how I got it but I’ve had it since I was 18 yrs old and before being sexually active. Yes, I know once you acquire in one location it is unlikely to acquire in other location. I’ve been told by one doctor and read it here. But I still have weird feelings down there I would say it’s acute and chronic throbbing on the L side labia and sometimes on the R side. I feel like it’s like the “Telltale Heart”. On my anus I feel irritation I’m checking constantly again yet I see nothing but some redness. I do suffer from constipation so maybe that’s the reason.Since HSV symptoms can be “hemorrhoids” “bug bites” “pimples” I’m going insane!I’ve seen a pimple here and there but they go away fairly quickly. Also I’ve been on valacyclovir for about 2 months now I take 1x daily same time every day. This should be preventing OBs right? Oh and now I feel every little sensation in my face and I freak out thinking it’s an OB coming and I’ve kissed my boyfriend. My mind goes on overload thinking I’ve infected him. My doctor said to consider myself STI free and continue with my medication move on. She has found nothing to think otherwise. I don’t trust the doctors anymore really though because of the lack of knowledge on HSV. Since I’ve seen a few doctors I’ve been told my 58.54 HSV1 antibodies means I have it in 2 locations. And if I had genital HSV I would have sores which I know is not true.I don’t need to take medication for HSV1(oral) it’s bad for your liver and you don’t need to tell anyone you have HSV1 everyone has it! And it’s all in your head 🙁 The valacyclovir RX I got from the dermatologist after telling him I had 2 OB’s this year which was not normal. I know it was due to the HSV2 scare.

[Terri Warren]

Your positive HSV 1 antibody test score has nothing to do with anything except to tell you that you have HSV 1, which is consistent with you have cold sores. Period. End of story. Valtrex is not bad for your liver. You now need to move on from thinking that you have an STI. Really.

So glad to hear your blot was negative.

Terri

[anxiety10]

So I’m slowing moving on though at times it’s hard because there’s still some sensations going on down there from time to time. I’m putting HSV-2 behind me I know the WB is not a 100% but it’s close 99.5%- I am negative. I’m very thankful for your service I think I would be more anxious without it! I have tested for everything including HIV 2x (all NEGATIVE) . I did test positive for HPV in October 2014. The September 2015 pap smear has come back normal. I have HSV-1 orally and that is all my gyno keeps telling me. I do have some more questions about HSV-1 and suppression along with transmission. My boyfriend is HSV-1/2 negative I would never want to pass my HSV-1 to him (no one ever does).

1) My gyno has said with me taking valacyclovir once a day transmission is close to zero I would like to believe that but I don’t * with the lack of knowledge of HSV some of these doctors have

2) Should oral sex (me giving) be taking off the table? I’m so scared to do so now

3) Since I’ve had HSV-1 orally for 17 yrs has shedding reduced? Just a reminder I didn’t acquire HSV-1 sexually (I don’t know how I did)

4) How is HSV-1 transmitted to the genitals exactly? Would his penis have to have a cut or abrasion? Or is it just any contact (my mouth to his penis)? *No, I would never perform oral with an active cold sore

5) I know there needs to be a certain amount of the virus present….. is time a factor? Such has giving oral for 5 minutes compared to a longer time?

6) And what about kissing?

7) If I do the WB for HSV-2 in 6 months (WB done in October 2015) and again it’s negative should I then consider it 100%?

8) What are your thoughts on HPV? I have some doctors that say it does go away in about 2 yrs then some tell me it never goes away I’m now in a monogamous relationship and I would like to have sex without condoms (I’m on birth control) My gyno said I could but still I am wary

Thanks again I truly appreciate your time and forum!

[Terri Warren]

1) My gyno has said with me taking valacyclovir once a day transmission is close to zero I would like to believe that but I don’t * with the lack of knowledge of HSV some of these doctors have

We don’t have good data on how much these medicines reduce the risk of HSV 1 tranmission.

2) Should oral sex (me giving) be taking off the table? I’m so scared to do so now

I don’t think so – it depends upon how much risk is he willing to take, i.e. any?

3) Since I’ve had HSV-1 orally for 17 yrs has shedding reduced? Just a reminder I didn’t acquire HSV-1 sexually (I don’t know how I did)

yes, it has decreased over time yes

4) How is HSV-1 transmitted to the genitals exactly? Would his penis have to have a cut or abrasion? Or is it just any contact (my mouth to his penis)? *No, I would never perform oral with an active cold sore

The penis skin is thin so if there is no cut needed for virus to get in, just mouth to penis contact.

5) I know there needs to be a certain amount of the virus present….. is time a factor? Such has giving oral for 5 minutes compared to a longer time?

The less time, the less exposure

6) And what about kissing?

Also some minimal risk

7) If I do the WB for HSV-2 in 6 months (WB done in October 2015) and again it’s negative should I then consider it 100%?

yes

8) What are your thoughts on HPV? I have some doctors that say it does go away in about 2 yrs then some tell me it never goes away I’m now in a monogamous relationship and I would like to have sex without condoms (I’m on birth control) My gyno said I could but still I am wary

Most people clear HPV within two years, correct

The screening test for HSV 1 misses one out of four infections, compared to western blot. He might want to consider getting the more accurate test to know for sure about his HSV 1 status. We can order that for him

Terri

[anxiety10]

I continue to struggle with the genital HSV1/2 fear. I have done 4 IgG tests which came back negative for HSV2 ..Positive for HSV1 (acquired well before any sexual activity) and I have done the Western Blot which was negative for HSV2…. Positive for HSV1 (expected) pretty close to a year after the HSV2 exposure (which was 0ctober 2014). Yet I still feel different down there it’s constant mild discomfort. Itchy, red anus comes and goes but it’s there every month
I’ve been to the ObGyn countless times she is adamant that I don’t have HSV2 she says blood tests/PCR swabs don’t lie. I never had any bumps or anything down there to swab but they did anyways 2x. I’m beginning to think maybe since I started on Valtrex (for oral HSV1) on September 2015 I may have caused a negative WB result. Or did I have enough time to produce HSV2 antibodies? I’ve seen the dermatologist 2x and he says there’s nothing there and consider myself lucky and move on. It’s hard though because I never had any issues down there until 10/14 so I assume it has to do with HSV. I wish I can believe the doctors but with what I have read on this forum of what some say just makes it difficult! And a nurse was the one who told me unprotected sex with a HSV2+ person was safe as long as there’s no lesions and skin is intact.

Outline
10/17/2014 unprotected sex with HSV2+ male
11/06/2014 IgG HSV2 negative LabCorp
12/11/2014 IgG HSV2 negative LabCorp
01/14/2015 IgG HSV2 negative LabCorp
07/07/2015 IgG HSV2 negative LabCorp
June/July PCR swab negative
Sept 2015 started taking Valtrex for HSV1
October 2015 Western Blot HSV2 negative

[Terri Warren]

I’m not certain what it is going to take for you to believe that you are HSV 2 negative. The western blot should really convince you. The medicine you started in September is not going to impact the western blot because you had plenty of time between your contact in 2014 to develop antibody. The testing is only impacted by antiviral therapy taken daily, immediately after new infection, before antibody has an opportunity to be made. But in your case, you had almost a whole year to make antibody before you did the western blot so take that off your worry list.

Terri

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