Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
STDs (Expert Forum)
HSV-1 Reoccurance
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
HSV-1 Reoccurance
by 9848, Sep 23, 2005 12:00AM
Dr.,
I have a question about genital HSV-1 reoccurances. I contracted HSV-1 via oral sex approximately 3.5 years ago. I have had (knowingly)a bad primary and one other reoccurance 1.5 years later in the perineum area. I also suffer from IBS where I get bouts of constipation which causes strain and fissures. During my primary outbreak, I was also constipated and had fissues along with lesions in the entire gential and anal region.
My recent outbreak (this would be the third knowingly), I am again suffering from constipation and fissures and thought that I had irritation due to the fissures, but when I went to my doctor she said the irriation (lesions) looked like herpes. I requested a culture of the fissures and lesions. The one thing I find strange is that the sores were on both sides (exactly on the same side) just outside the anal area forming a perfect circle. My doctor has never seen this before and stated that most HSV that is a reoccurance would be a small cluster on one side. Indeed, it feels more like the first primary outbreak, not the second where there were a few blisters in a cluster. I do not think I have been infected with HSV-2 as I have had only one partner since contracting HSV-1 3.5 years ago. I had sex with this partner a total of 3 times and we used a condom - I was also on Valtrex.
If this is true that each time I have soreness in the anal region, it might be herpes and not due to IBS or fissures is this normal? I am a healthly, young person. With statistics being that 40% of folks with HSV-1 never getting a reoccurance and 50% of folks getting one or two reoccurances than nothing (I thought I was in this category), could there be an underlying concern with my immune system? I find it disturbing that I could be in the minority when it come to reoccuring HSV-1. The culture should be back next week. If negative, my plan is to go back to the doctor's if I notice anything red or out of the ordinary for a culture so I can know for sure how often I am having a reoccurance. Thanks for your help.
I have a question about genital HSV-1 reoccurances. I contracted HSV-1 via oral sex approximately 3.5 years ago. I have had (knowingly)a bad primary and one other reoccurance 1.5 years later in the perineum area. I also suffer from IBS where I get bouts of constipation which causes strain and fissures. During my primary outbreak, I was also constipated and had fissues along with lesions in the entire gential and anal region.
My recent outbreak (this would be the third knowingly), I am again suffering from constipation and fissures and thought that I had irritation due to the fissures, but when I went to my doctor she said the irriation (lesions) looked like herpes. I requested a culture of the fissures and lesions. The one thing I find strange is that the sores were on both sides (exactly on the same side) just outside the anal area forming a perfect circle. My doctor has never seen this before and stated that most HSV that is a reoccurance would be a small cluster on one side. Indeed, it feels more like the first primary outbreak, not the second where there were a few blisters in a cluster. I do not think I have been infected with HSV-2 as I have had only one partner since contracting HSV-1 3.5 years ago. I had sex with this partner a total of 3 times and we used a condom - I was also on Valtrex.
If this is true that each time I have soreness in the anal region, it might be herpes and not due to IBS or fissures is this normal? I am a healthly, young person. With statistics being that 40% of folks with HSV-1 never getting a reoccurance and 50% of folks getting one or two reoccurances than nothing (I thought I was in this category), could there be an underlying concern with my immune system? I find it disturbing that I could be in the minority when it come to reoccuring HSV-1. The culture should be back next week. If negative, my plan is to go back to the doctor's if I notice anything red or out of the ordinary for a culture so I can know for sure how often I am having a reoccurance. Thanks for your help.
Doctor's Answer
by H. Hunter Handsfield, M.D., Sep 24, 2005 12:00AM
, Sep 24, 2005 12:00AM
Although it is uncommon for people with genital HSV-1 to have frequent recurrences, a few percent of such persons have frequent outbreaks. However, your assumption that you do not have HSV-2 is not well-founded; lots of people seemingly at low risk for traditional STDs nevertheless get HSV-2. Also, sometimes errors are made in initial diagnosis: how certain are you that your initial infection was HSV-1 and not HSV-2?
I'm not in a position to tell whether your recurrent anal lesions are herpes, fissures related to IBS, or something else. You and your doctor are right that recurrent herpes generally would be localized to one side or the other. However, if you have a dual problem--both non-herpetic fissures and herpes--HSV could easily contaminate the fissures. Your doctor also is the person to ask about immune system problems, possibly related to drugs you might be taking for IBS (e.g., steroids and others). However, frequently recurring herpes is not usually the result of immune dysfunction.
My only specific advice is to suggest you have blood tests for HSV-1 and HSV-2 antibody (see other threads to make sure your doctor orders the right test, such as HerpeSelect); and also have viral culture of your recurrent lesions to determine virus type. If the lesions are herpetic, treatment with valacyclovir or related drugs should be pretty effective in preventing outbreaks.
Good luck-- HHH, MD
I'm not in a position to tell whether your recurrent anal lesions are herpes, fissures related to IBS, or something else. You and your doctor are right that recurrent herpes generally would be localized to one side or the other. However, if you have a dual problem--both non-herpetic fissures and herpes--HSV could easily contaminate the fissures. Your doctor also is the person to ask about immune system problems, possibly related to drugs you might be taking for IBS (e.g., steroids and others). However, frequently recurring herpes is not usually the result of immune dysfunction.
My only specific advice is to suggest you have blood tests for HSV-1 and HSV-2 antibody (see other threads to make sure your doctor orders the right test, such as HerpeSelect); and also have viral culture of your recurrent lesions to determine virus type. If the lesions are herpetic, treatment with valacyclovir or related drugs should be pretty effective in preventing outbreaks.
Good luck-- HHH, MD
Sorry I forgot to add that the individual that transmitted HSV-1 to me was not HSV-2 positive (or at least not to my knowledge, I dated him for two years..). The other partner I mentioned (we were together about 2.5 months ago), to my knowledge did not have HSV-2 and we used protection the three times we were together. That info might matter. My primary infection 3.5 years ago was cultured and diagosed as genital HSV-1. Prior to being with the two year relationship I was in a marriage and monogamous for 15 years and my husband did not have HSV-1 or HSV-2.
I am pretty certain the inital diagnosis was correct it was a type specific culture. My partner had a history of recurrent cold sores.
I went immediately to the Doctor for a culture - true primary. Fever, lymph nodes swollen, pain etc.
How accurate are cultures in this case? I plan on getting tested for HSV-2 next week and my doctor cultured my current outbreak yesterday.
You mentioned that HSV can infect fissues? My doctor seems to think that I was having an outbreak and complications from IBS. I remember during my primary however, I did have a bout with constipation and fissues....
My plan is to see a specialist about the IBS...
Thanks Doctor -
Sorry Doctor forgot to address comment to you!!
I am pretty certain the inital diagnosis was correct it was a type specific culture. My partner had a history of recurrent cold sores.
I went immediately to the Doctor for a culture - true primary. Fever, lymph nodes swollen, pain etc.
How accurate are cultures in this case? I plan on getting tested for HSV-2 next week and my doctor cultured my current outbreak yesterday.
You mentioned that HSV can infect fissues? My doctor seems to think that I was having an outbreak and complications from IBS. I remember during my primary however, I did have a bout with constipation and fissues....
My plan is to see a specialist about the IBS...
Thanks Doctor
Good luck sorting things out.
HHH, MD
I have one more question. You said that Herpes could contaminate my fissures. I got my current fissures via trauma from a bowel movement a couple of days prior to my herpes outbreak. As discussed above, the multiple fissures (on both sides)were in the anal opening (hard to see by just looking in the mirror) and the lesions (that my doctor feels is herpes)were in a "circle" around the anus. Are you saying that herpes