Test results positive

[fletcher]

Hi Terri,
Thank you for this service, it makes it much easier for me to get answers here than anywhere else.

I’ll try to lay out the salient details of my situation to suit my questions;
-Received results 9/14 (tested week prior) HSV Type 2 IgG positive >5 A
Seems like a confirming test would be moot, right?
-I am male
-Last encounter August 1, 15; oral both ways, no condom, no vaginal. Prior intimacy was 7/12, same.
The reason I give you that is I’m curious if you can provide an educated guess of how likely it was one of those two were the events where I may have contracted HSV 2.
-I used condoms during vaginal intimacy except for select times dating back to 2003 and before.

Questions;
How likely is it I contracted HSV 2 via receiving oral sex? (likelihood with or w/o condom)

At one point last year I went to my dermatologist with what I though was heat rash or poison ivy on my inner thighs, I had had it before (diagnosed as poison ivy, but not necessarily in that location, although close. It was never close enough to the genitals for me to even consider it might be an STD, but that said, do you think a dermatologist would have been able to decipher that as an outbreak if was in fact, an outbreak?
The thing about that, all I remember was that it itched somewhat, didn’t really bother me otherwise, no blisters that I recall etc…
Obviously I’m wondering if that was an outbreak. I’ve never had anything like it before or since which leads me to my next question.

Can you give me a percentage on the likelihood Ive had HSV 2 for 15-25 years with no issues?
With this diagnosis, I’m wondering, because it just doesn’t seem likely that I’ve contracted it in recent years. I realize you can’t comment without knowing more details, but suffice it to say vaginal intercourse for me was scarce. Very. Which is why I asked the oral question, but I digress.

Much of what I read said an outbreak was likely within 2-14 days. If that isn’t the case, is there a % a first outbreak will occur if Ive been infected for a year or more? If that rash I had wasn’t the poison ivy, is there a % suggesting a second outbreak will occur?

Moving past the outbreak, shedding confuses me. What are the numbers relating me to me transmitting …
if someone has sex with me with no symptoms, no anti virals and a condom?
If I were to receive oral with or without a condom?
If I perform oral?

I understand meds (I have valacyclovir 500mg to be taken daily) help suppress outbreaks and reduce transmission, is that true? I don’t take them daily (Im not in a relationship right now) because potential harm to kidneys bother me plus Im not a big pill taker. But how soon before an encounter would I have to take them in order to achieve effectiveness?

The one thing that truly disheartens me about this virus is the increased chances I have to contract HIV.
So I want to ask the same questions as above as for as numbers go for my risks.

Lastly, just so I know when I have to have the talk…am I right in that 1 in 6 people have HSV2 and within that range, 1 in 4 are women? I also read that for a white male who uses a condom, percentages are very very low to receive HSV 2. My life story lol Sorry, trying to be as lighthearted as I can… but if transmission rates are so low, how can 50 million people be infected? It’s confusing to me.

Summary;
I feel like I have had this for 15 years or more with no outbreaks unless you tell me different. I walked into the STD clinic simply because my deductible had been met and I thought why not. When they gave me the results, I had to inquire about HSV because as I learned thats not normally in the initial panel. So, had I not done that, I still wouldn’t know, so it hasn’t affected my life when I think of it in that manner, but the HIV and me transmitting does bother me now.
Now not only do I have to have the talk and wait for someone to decide if they want to be with me, I have to ask them to have testing since Im at an increased risk for HIV. This isn’t going to be fun, but it’s necessary, I guess.
I realize Ive asked you a plethora of questions requiring vague responses and I truly appreciate your time. It’s just nice to outlet to someone you know has truthful information and will not mislead you.

[Terri Warren]

It is extremely unlikely you acquired HSV 2 from oral sex.
At an index value of >5, there is no way to know how long you have been infected. I have only had one person in the past five years who had an index value of >5 NOT confirm with western blot.
The rash on the thigh could certainly have been HSV, yes. You wont’ have a first outbreak – if that happened, it happened a ways back. You may not have had an outbreak when you first contracted the virus.
You mention that intercourse was infrequent – can you tell me about how many times you’ve had intercourse, condom or not?
We have no information about transmission to someone else’s mouth. If you use condoms with every intercourse and take daily antiviral and have informed your partners of your status and avoid sex during symptoms, the risk of transmission, having sex twice a week for a year, is likely somewhere around 3%.
In terms of HIV risk, I would certainly hope that you are having partners tested for HIV prior to having sex. I think that should happen regardless of whether you had herpes or not.
I have no concerns about kidney issues with Valtrex. You would need to take meds at least 5 days for greatest protection against transmission. It is not perfect, but it is very useful.
Transmission rates are high because most people who have herpes have no idea that they have it (80%) and are therefore doing nothing about reducing the risk of infecting others.

Terri

[fletcher]

Thank you for the quick response!
This part of your answer confused me…
You wont’ have a first outbreak – if that happened, it happened a ways back.
Regarding the dermo visit, there was an encounter a week prior, but I can’t recall if it was vaginal and, knowing myself, it likely took more than a week for me to get to the doc, but now my mind is convincing me that was an outbreak. I guess it doesn’t matter now anyway.

Frequency for vaginal sex was not often in the last 10 years., Perhaps three to four times a year.
Much more often in the preceding decade.Which is why I initially felt I had it for a long time, but, I guess if we deduce that rash was an outbreak, I have my answer.
Assuming that was an outbreak, am I likely to get another, considering that was not so painful as other stories Ive read?
If it wasn’t an outbreak, am I likely to have one?
As I read this, I realize there are no answers and probably moot anyway.

With regard to the kidney concerns with Valtrex, would your opinion still hold if I had history of kidney stones?

I neglected to ask you about this topic and I don’t know if you are the one to ask, but regarding vaccines or booster shots concerning shingles. Should I get one? Before my diagnosis, I was seriously considering it anyway if for no other reason than just protection.
Oh and, was the 1 in 6 people being HSV 2 positive a correct statement?
I think that is all the questions I have although Im sure I can come up with a few more since I have another post coming 🙂
Thank you again!

[Terri Warren]

A primary outbreak, if it is going to happen, is defined as something that happens within 2-10 days, usually, of first infection. This is not true for you. What you are describing might be first RECOGNIZED outbreak – see the difference? It really doesn’t matter much though

You would not achieve and index value of >5 in one week. It takes a while to get to that index value.
Now that you know that you are infected, you may recognize an outbreak or you may not have any outbreaks.
Only a person with decreased kidney function needs to be concerned about the dosing of the antivirals. This is something you should discuss with your prescribing clinician.
Depending upon your age, the shingles vaccine is appropriate. If you are taking daily antiviral therapy, you need to stop about 5 days in advance as this is a life vaccine and not take medication for two weeks afterwards.
Yes, one in 6 adults in the US

Terri

[fletcher]

Age is 50, so yes to the singles vaccine?

From our discussion, I infer a confirming HSV 2 test is moot?

Are HSV 2 infected more likely to contract HIV during times with no outbreak?

There is no information on transmitting HSV 2 via oral sex is how I read your answer, that correct?

I assume its reasonable for me, in order to establish a time line for myself, to count that rash as my first outbreak, understanding it may not have been.

I’m not really a big pill taker, but, including you, two professionals thus far have said not to worry about kidney side effects so that eases my mind a bit. Understanding it is different for everyone, are there common side effects to this medication? In your experience, what signs should I keep an eye out for in the future?

I won’t be able to respond again since this is my last post, so again, let me say thank you for your service to the community. It’s really difficult to glean solid information from the internet given the ease of misinformation and can be quite confusing.
I also read your book which helped as well, it is appreciated.

[Terri Warren]

I doubt that you will get insurance to pay for a shingles vaccine at age 50 but you can get the vaccine.
I have only had one person with an index value of >5 not confirm.
You can count the rash as whatever you like, but it is not the results of a new infection nor do we even know if it is herpes! Not exactly sure why that is important to you but maybe I’m missing something here.
The most common side effects for these medicines are headache and nausea and I find that for most everyone, those side effects pass within the first month or so.
Be aware of breaks in the skin anywhere in the boxer shorts area – outbreaks can show up on the belly, anus, buttocks, thigh.

I’m glad the book and the forum were helpful for you. If you have more questions, you can always renew for more questions.

Terri

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