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1 I understand the false negative rate is low but I think the clinical suspicion is high for HSV considering the presentation of ulcers and breaking of the skin on my labia minora. I believe the swab timing was good but PCR testing is not perfect. How many cases have you seen of valtrex causing a false neg PCR swab? How do antivirals interfere with PCR swab testing? is is possible that shedding of the sore is intermittent even though it is an open sore, and therefore there was no virus on the sore or is there always virus there when there is an open sore?
I don’t know if I’ve seen Valtrex interfering with a swab test – how would one know? It is possible that the Valtrex interfered with the swab, yes, but you took it so soon after a symptom appeared – seem like it would have picked up here but it’s possible the meds interfered, yes.
2 Why do you say valacyclovir unlikely would cause a false positive? I am trying to understand better.
I don’t think I said Valtrex would cause a false positive, and if I said that, that was an error
3 So you are saying that you haven’t seen or heard of cases when someone got genital HSV earlier in life and it be dormant (asymptomatic) for 15 or 20 plus years and showed up later?
No, I have, that is possible, but I thought we were talking here about you transmitting virus from your mouth to your genital and I said that with all the time that you’ve had HSV 1, having that happen recently is unlikely. It is possible that you got this years ago but with no symptoms genitally until now, that seems unlikely
4 I do remember touching myself with my hand on my right labia (carelessly) without washing my hand a few months ago. Let’s say that there was HSV 1 virus on my hand (I was eating food shortly before touching the labia and had saliva on my hand) and I touched my labia using that hand/finger 5/10 minutes later, did I autoinfect? I didn’t start having genital sx until after this incident.
I don’t believe you did, because your oral infection was so well established a few months ago
5 My husband is very concerned about HSV and requested we don’t kiss/oral sex. He does not want to take chances and am OK with it as I don’t want to give it to him. That is why it is VERY IMPORTANT I KNOW IF I HAVE GHSV OR NOT. It could end our sex life. Are there underwear condoms that would cover his entire pelvic area? what % does condoms reduce risk of transmission from w to men using condoms? What are the best things I can do to reduce my risk of infecting him with gHSV and what is that transmission risk decreased down to doing all those things? If we don’t know from data, what is your estimated guess? I am willing to do whatever I have to do.
I am not aware of any underwear condoms, no, but you could look online. Condoms reduce transmission of HSV 2 (we don’t have data on HSV 1) by 65%. If you are also taking antiviral medication, that may reduce it more, we don’t have any data on the reduction of transmission of HSV 1 as it is such a rare event to start with.
6 if this is a new infection, should I hold off sex for a year or 2, and what is shedding rate?
It is not a new infection because you have it orally. If you believe that you gave it to yourself months ago, it is also not a new infection. I really can’t advise you on how long you should not have sex since you’ve had the oral infection for years.