Looking for answers

[Hopeless28]

Hello and thank you for offering this service!

I began a monogamous relationship in June. We were careful with using condoms the first 2 months of dating but had our first unprotected encounter the beginning of August. I contracted bacterial vaginosis, followed by a yeast infection, and later trichomoniasis. The infections have been continuous since then. My latest diagnosis of BV was accompanied by what I would describe as rug burn on my inner labia. It itched a bit but was not painful. I thought this may have occurred because I was a bit overzealous about keeping myself clean and dry. I noticed it on a Saturday, Sunday it was gone, and it returned on Monday. I went in the get examined that Monday and my OBGYN said she didn’t see anything. I decided to get tested anyway. My HSV1 was 50.4 and HSV2 was 2.3 via Herpeselect. Of course I was shocked. I calculated from first unprotected sex to results and 8 weeks had passed. I’ve never had any genital symptoms nor had any type of infections prior to my current bf. The only questionable symptoms that I had was a really bad sore throat and nerve pain. My last sexual encounter prior to my current bf was January 2014. We had unprotected sex twice within the 6 months we dated. I’ve read so much online and have a few questions…

1. Should I let time pass and get retested? Or should I seek out the Western Blot immediately?
2. Could I have been carrying the virus and “symptoms” were activated by the BV or new sex partner?
3. Have you seen a link between recurrent BV/yeast infections and Herpes?
4. If I retest and get results greater than 2.3, should I assume my boyfriend gave me the virus (if I have the virus)?
5. Have you seen herpes cause chronic irritation?
6. Have you seen symptoms come and go like mine have?

Thank you so much!

[Terri Warren]

1. Should I let time pass and get retested? Or should I seek out the Western Blot immediately?

I think if you were my patient, I would recommend that first your current partner be tested. If he is negative for HSV 2, then I think you could go ahead now and get the western blot – enough time has passed (unless you are concerned that he has had another partner while with you). When we calculate when to have a western blot, we suggest that the counting be done from the LAST sexual contact, not the first, because you could acquire HSV 2 at any time during a sexual relationship, not necessarily with the first intercourse, right? that is the most conservative way to count time to testing. So if he is positive, let’s say, and you just got herpes from him, then the western blot might not yet be positive. Is he willing to test? You an do it online without a clinician order, you want the IgG test not the IgM test.

2. Could I have been carrying the virus and “symptoms” were activated by the BV or new sex partner?

You could certainly have been carrying the virus for a while and not known it. It would not be “triggered” ‘by BV or a new partner however.

3. Have you seen a link between recurrent BV/yeast infections and Herpes?
I think there is a small statistical link between BV and the acquisition of new herpes, yes, as I recall from a recent research paper.

4. If I retest and get results greater than 2.3, should I assume my boyfriend gave me the virus (if I have the virus)?
No, if you test below 3.5, it still needs confirmation. At 2.3, there is about a 60% chance that this is a false positive. If your boyfriend tests negative then I would strongly suggest a western blot for clarification of your status.

5. Have you seen herpes cause chronic irritation?
Not really

6. Have you seen symptoms come and go like mine have? Yes, I have.

Are you sure you were diagnosed with trich or were you just treated presumptively for trich?

Terri

[Hopeless28]

Thank you for your response! I have talked to my boyfriend and he is going to get tested. I do not know what his herpes status was prior to our dating. I know this is super irresponsible but herpes has never been on my radar. I do want to clarify some of my questions. If I were to get retested and say my index would be hsv2 >5, does this indicate that it is probably a recent infection since I tested 2.3? I’m trying to understand the whole seroconversion process. Have I been with my current partner long enough to have a positive blood test (if I am truly positive)? Have you seen many false positives in the 2.3 range? I read somewhere that a new sex partner could cause dormant herpes to start causing symptoms. I just find it puzzling that I was fine after my last partner in 2014. I hadn’t had sex since then and all of a sudden once I start again, “symptoms” begin. Yes, I was diagnosed with both BV and trich via lab work. My boyfriend and I were both treated. My ideal situation would be that I’m having recurrent BV and yeast infections and none of it has to do with herpes.

[Terri Warren]

If your value is now >5, it MIGHT indicate seroconversion, yes but not every time. Values can vary quite widely. About half the time people who test in the range of 2.3, they are false positives. Let’s see what your partners test results show before doing much more. If he is positive, then you might get another screening test and see what your index value is. If it is >5, you won’t need a western blot. But if he is negative for HSV 2 and/or your screening test is once again in the low positive range, a western blot is needed here.

terri

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