March 6, 2020 at 8:52 pm #69519
I have had genital HSV1 for 10 years and today a blood test confirmed that I also have HSV2. Because I knew I already had herpes, I was not testing for herpes at regular checks. My last test confirming HSV2 negative was several years ago. 3 months ago I had very painful bladder infection symptoms that persisted for about 3-4weeks. I had been to urgent care multiple times and no signs of bacterial infection. I assumed this must have been the HSV1 I already had, even though after 10 years of infection my outbreaks are usually extremely mild and short. About a week ago I noticed a pea sized bump on my labia that was somewhat tender. I NEVER get herpes bumps. My lesions are always always cuts only, no bumps. I decided to go get the test to rule out HSV2 because at this point I was very suspicious of a new infection.
I have been having sex now with the same person for 4 months. I am 90% sure the HSV2 is from him, but I am afraid to bring it up because I think he might blame me for infecting him if he does not know he has it. Is there any any any way to confirm that what I have is an infection that was acquired RECENTLY (in the last 4 months or less)?
March 8, 2020 at 11:03 am #69523
First of all, what is the index value of your positive HSV 2 antibody test? And was it an IgG or IgM?
If the index value is high, there is no way to know when you were infected, no, not if your last test was years ago.
While it is uncomfortable to bring this up with him, I think you should. If he is negative and you are truly positive, then you need to have this discussion about what to do next. I am assuming that you have had unprotected intercourse with someone in the years between your negative HSV 2 antibody test and this person?
March 8, 2020 at 11:35 am #69527
I’m not sure how to interpret this so I will copy and paste:
HSV-2 Type Spec Ab, IgG w/Rflx
– Abnormal lab results –
* HSV 2 IgG, Type Spec: 9.36 index (Range: 0.00-0.90) Above high normal
Equivocal 0.91 – 1.09
Note: Negative indicates no antibodies detected to HSV-2. Equivocal may suggest early infection. Ifclinically appropriate, retest at later date. Positive indicates antibodies detected to HSV-2
Yes, I have had other partners over the years but there has been no significant change in the severity of outbreaks until I started have sex with the new partner 4 months ago. So I cant be certain the hsv2 is from him, but it seems to me like the most logical explanation for the 3 week intense outbreak I experienced a month after we started having sex and the abnormal outbreak I had 2 months after that.
I started doing 1000mg daily valtrex suppression about a year ago for the hsv1 that I knew I already had. I honestly cant remember if it was working all that well (my outbreaks were mild I think the drug reduced the frequency maybe a little bit) but once the bad outbreaks started happening 4 months ago I started the think the valacyclovir did nothing and if anything made things worse. So desperate for relief I started taking 3grams daily of the valacyclovir during the 3 week outbreak I described. At about week 2 of no relief I convinced a doctor to put me on famvir in addition to the valacyclovir. Is there any real consequence to taking both simultaneously? Or can I take more than 1gram valtrex daily? I am really relying on the drugs at this point and I worry that the recommended doses are just not enough for me. I care a lot more about avoiding outbreaks and transmission than I do about liver damage.
March 15, 2020 at 2:27 pm #69565
I think taking Valtrex and Famvir at the same time is a bad decision. And this isn’t helping your outbreak, I strongly suggest that you have a swab taken of the outbreak and 1) be sure it’s actually a herpes outbreak and 2) see if you have a resistant strain of the virus (that would be very rare). What exactly are the symptoms that you’ve had for three weeks? A recent study found some benefit from taking Valtrex with omeprazole, a medicine usually used for heartburn. I’m just reporting the study, not making any official kind of recommendation.
Acquiring a new strain of the virus is unlikely but frequent intercourse can be a trigger for some people.
- This reply was modified 2 months, 1 week ago by Terri Warren.
March 15, 2020 at 5:07 pm #69598
The symptoms that I had for three weeks occurred 3 months ago. I had pain in my urethra that felt exactly like that of a uti. I was tested multiple times for bacteria in my urine, every test was clean. I even went to see a urologist for a cystoscopy, also normal. It was very bad, I actually missed work for being in too much agony to focus. The more recent outbreak was a bump on my labia that broke out into a blister and eventually healed after a week but lingering itchiness and mild pain in the general area for a total of about 2 weeks of symptoms. My outbreaks (from having hsv1 for 10 years) are typically shorter than 4 days and do not present with bumps.
I would be interested to know if the strain is resistant so I can make a better decision as to whether I should keep taking the valtrex. I would, however, have to wait until i have open sores to find that out. And how would I know if the hsv1 or the hsv2 was resistant? Since I do have both now.
Why do you feel that taking both drugs simultaneously is a terrible idea? I am open to trying valtrex with omeprazole. And maybe I just need more time for my body to get used to having hsv2 before my symptoms are mild again. To be honest though, I do feel very frustrated that i cant control the outbreaks on 1gram valtrex daily and i just dont understand why I cant or shouldn’t take more than that.
March 19, 2020 at 1:00 pm #69627
I would think if you had a cystoscopy and had herpes lesions in the urethra, that would have been seen and noted. So if I am reading this correctly, you had the UTI symptoms 3 months ago and just recently had a lesion that lasted about one week with some residual pain. And that occurred while taking antiviral medicine daily?
While we know that the doses that have been approved (1 gram daily or 500 mg daily of Valtrex) are safe for long term use, we have no safety data for liver and kidney on larger doses on an ongoing basis, nor do we have data on combining these two medications, both in the same drug category. For that reason, I certainly wouldn’t recommend that or prescribe it. We do know that people can safely take 1 gram of Valtrex three times a day for a week or two, based on shingles studies, but nothing beyond that.
If the above is a description of the normal frequency of recurrences (and you said the average is about 4 days), this is not inconsistent with what we’ve seen in terms of suppression.
One thing you could try is taking 500 mg twice a day to keep your drug levels nice and high and avoid the dip we sometimes see with once a day therapy, which might allow for more outbreaks.
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