HSV2 inside Nostril – transmission risk?

[rmakas]

Hello,

I’ve tested positive for HSV2. I believe my initial outbreak was a single blister on the very tip of the inside of my left nostril – it was painful like a pimple, lasted about a week, and I think it crusted over a little bit. I can only assume I got it from performing oral sex on an infected partner, since that part of my nose could come in contact.

Since then, in the past couple of months, I’ve had three similar occurrences in my left nostril, all further up (2-3 cm) inside the left nasal cavity. Once at the onset of a cold, and twice somewhat randomly.

Please help me understand the transmission risk with my partner:

– Since the site of infection was my left nostril, and HSV2 can shed all the time, my left nostril should always stay out of contact (i.e., during cunnalingus). Are my lips also at risk and always shedding – i.e., kissing could at any time transmit the virus?

– Are my genitals a potential point of transmission, even though the infection seems to be confined inside my nose?

Here are my test results to date (single partner, no antivirals). Western blot was expensive and useless in my case.

2015-03-11 LabCorp IgG HSV1 < 0.90, HSV2 3.55

2015-05-24 Western Blot: “Low level antibody detected by Western blot assay. Indeterminate for HSV. No antibody to herpes simplix virus type 1 detected by Western Blot Assay. Atypical reactivity was noted against proteins on the HSV-2 Western Blot.”

2015-07-28 Western Blot: Exactly same result as 2015-05-24

2015-12-04 IgG type-specific Herpeselect: HSV 1 IgG < 0.90, HSV2 iGG 4.98

Thank you for your help!

[Terri Warren]

Have you had swab testing done of the inside of the nares when you get these symptoms? Your situation is pretty unusual. If you do have HSV 2 in your nose, it certainly is recurring very often for HSV 2 orally. I mean, it’s possible, of course, but just really unusual. My advice, since you are getting these pretty often is to get them swab tested at the very onset of each one. And be certain the test used is PCR, not culture as culture turns out to be not all that sensitive for HSV. If your local provider does not have PCR, the clinic can send you some swabs to gather at home, but all big labs now (LabCorp included) run PCR – the swabs are the same as for culture, you just need to have the provider ask for HSV PCR instead of culture.

Also our clinic is doing a research study of people who have indeterminate western blots. If you are at all interested in participating, please contact Basak in our research department and she can get you enrolled.

Terri

• This reply was modified 7 years, 9 months ago by Terri Warren.

[Terri Warren]

If a person has an HSV 2 lesion in the facial area, there is a reasonable chance that they are also infected genitally, yes. We know that the vast majority of people who test positive for HSV 2 antibody shed virus from the genital tract.

If you would like to have our clinic send you PCR swabs, you will need to call and set up a phone consultation so we can discuss this with you.

Terri

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