Question on Potential GHSV-1

[iPhoneUser1357]

Hi Terri,

About 6 months ago, I had a red swelling at the tip of my penis and a burning sensation when I peed in that same region. I wasn’t particularly worried as I had 1-2 similar symptoms previously in my life which went away after a couple of days (one doctor’s explanation was it may have been related to hygiene as I am not circumcised; possibly something fungal) but decided to go see a urologist (in a non-US country). They collected my urine, which tested positive for HSV-1. I was prescribed Valtrex, and after taking Valtrex for a few days, the symptom went away (I had the symptom for about a week, and then took Valtrex for a few days). I have seen pictures of blister breakouts online (whether around mouth or in genital region), and I have never had any such breakouts of painful blisters in either region of my body.

Based on this, I have just a couple of questions for you:
1. Based on the above, do you believe the symptom I experienced was a GHSV-1 breakout, or is it a possibility that I have HSV-1 that was detected via urine (possibly dormant) but the symptom was something separate?
2. Would you recommend that I do a follow-up test and if so, which type of test? I have not had any “breakouts” or symptoms since 6 months ago, but I would definitely like the peace of mind of knowing whether I definitively have or do not have active HSV-1.
3. This is perhaps a separate topic, but is it possible to get active HSV-1 in both the mouth and the genital region?

Thank you so much for your help.

[Terri Warren]

1. Based on the above, do you believe the symptom I experienced was a GHSV-1 breakout, or is it a possibility that I have HSV-1 that was detected via urine (possibly dormant) but the symptom was something separate?
I’m sorry but I would just have no idea. I am unfamiliar with the accuracy of the urine test for the presence of herpes virus. But if it was me, I would probably follow up with a really good antibody test. However, it just be one is incredibly common about half the people in the US are infected.\

2. Would you recommend that I do a follow-up test and if so, which type of test? I have not had any “breakouts” or symptoms since 6 months ago, but I would definitely like the peace of mind of knowing whether I definitively have or do not have active HSV-1.
Even if you do an antibody test and it is positive, it will not tell you the location of your HSV one infection. The only way to know if you have HSV one at a given location is to have a swab test done of a particular symptom and if it is positive, then you would know where your infection is. Have you ever in your life had a cold sore on your lip or in your nose? If the answer is yes, then we know that you have it orally at least.
3. This is perhaps a separate topic, but is it possible to get active HSV-1 in both the mouth and the genital region?

Yes, it is possible to acquire HSV one in both locations at the same time. Usually that happens when you kiss someone and they also give you oral sex and you get it in both locations. That’s not common but it does happen.

Terri

[iPhoneUser1357]

Terri,

Thank you for your response.

To answer your question, I don’t believe I have ever had anything resembling a cold sore anywhere near my lips or the genitals area, which was why the positive result was surprising to me.

Yesterday, I received a Herpeselect IgG test at LabCorp for both HSV-1 and HSV-2 and both tests came back with just “negative”, without a specific IgG value. It says that the range for negative is <0.91. Should this give me additional peace of mind or is the false negative rate high enough with these tests that you would recommend further testing?

Thank you.

[Terri Warren]

I think it should give you some peace of mind, yes, but the IgG test from LabCorp and Quest miss 30% of HSV 1 infections and 8% of HSV 2 infections, compared to the gold standard western blot.

Terri

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