5-day (and counting) Herpes Prodrome?

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I'm convinced I have herpes.  Eight days ago, I had intercourse for the first time with a guy I'd been dating.  Before we had sex, I told him I'd recently been tested and asked if he was too.  He said he was but in hindsight I was stupid to trust him.  Three days later I began to have stinging/itching/burning pains in a few different areas throughout my genital area.   I held on and have been waiting for sores to appear, but its now been 5 days of these same symptoms and there is still nothing.  A couple days ago some strange abdominal pains began.  I'm uncomfortable and scared.  The guy has been evasive about seeing me again.  I went to a health clinic two days ago and, in addition to other STD tests, the NP took herpes cultures of the different areas where I described the pain.  She said everything appeared normal to her, though.  Unfortunately, the results take a week to come in and she wouldn't start me on antivirals (which is what I really wanted) without lesions.

My questions are:  If there are no lesions, can a herpes culture return a positive result?  Are herpes cultures reliable?   I've also read that early antiviral treatment (within the first few days of infection) can reduce recurrences.  Is this true?

Also, I was told that I was HSV-1 positive after my last testing a few weeks ago.  I was shocked because I've never had an STD or cold sores.  Is it true that HSV-1 seropositivity offers some protection against HSV-2 and could this account for my mild symptoms so far?

Finally, and most importantly, I had a date with an ex-boyfriend a couple of days after the first encounter - before I started experiencing symptoms.  We had sex, and I worry that I could have infected him too.  This is my biggest concern because it would kill me to know that I hurt him.  Could I have?  I'm afraid to call him about it because I know he'd hate me for it.

I feel so dumb and ashamed of myself for being so irresponsible.  I just can't stop crying as I write this.

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A related discussion, Never been so scared... was started.

[Terri Warren, RN, Adult Nurse Practitioner]

There are different strains of HSV 2, yes.  The impact of the virus seems to depend most upon an individual immune system response.  Glad you have tested negative so far!

Terri

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I found out today that the herpes culture and all my results were negative:). I am still concerned about the HSV 2 test in a few months, though.  
If I do have HSV2, aree there different strains of HSV2 such that my symptoms may be mild and I could pass it on to someone who'd also develop mild symptoms or are mild symptoms explained solely by the infected person's immune system? Terri, thanks for your advice - getting reliable info has really helped me handle the anxiety!

[Terri Warren, RN, Adult Nurse Practitioner]

If you've never had a cold sore, then it isn't possible to know if your HSV 1 infection is oral or genital.  If you develop symptoms in either location you should go in and have them evaluated right away.  

I think you are wise to play it cool and friendly with this person.

Do let me know about the culture.  I'm betting money it is negative.

Terri

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Thanks, Terri.  I've not described my concerns to him and I'm not sure I want to unless I know something for sure.  He's been careful to text me everyday rather than call me and wasn't interested in meeting with me this week.  That certainly doesn't ease my concerns!  I'm going to hang tight and try to stay on his good side, because if I upset him, he won't cooperate.  I have no problem paying for his testing but he does very well and makes several times what I do so I don't think my offer to pay for testing would convince him to go.

The good news is that 1) My ex-boyfriend called me yesterday and seemed happy as ever and 2) my symptoms aren't getting worse and may actually be improving a bit yesterday and so far today.

Question: I'm apparently HSV-1 positive but have never had an oral or genital lesion.  Is that possible?

I'll let you know what the HSV-2 culture shows when I find out next week:)  Thanks!

[Terri Warren, RN, Adult Nurse Practitioner]

If there are no lesions, yes, virus can be present on the skin and this virus can make a culture positive.  Herpes cultures are reliable if positive, but if negative not necessarily reliable.  A PCR swab test is better.  I agree with her that starting antivirals with no lesions present is a good idea as you may want to test later and the medicines could interfere with accurate testing.  Good call on her part.  As for immediate antiviral therapy with new infection, the results are mixed, at best, in studies that look at this issue.  I personally doubt that it makes a big difference, but I could be mistaken.  

HSV 1 seropositivity could indicate either oral or genital infection, no way to know by a blood test.  If you get symptoms in either location, you should present to your clinician as soon as possible for evaluation.   It doesn't protect again HSV 2 acquisition (though, again, there are some mixed results on those studies), but what we do know for sure is that is protects against getting big symptoms, for most people.  

If you did get infected when you think you did, yes, you could have infected your boyfriend.  I don't really think you are obliged to call him unless you get specific symptoms or your antibody test at some point is positive, then I think you should.  

Right now, it is impossible to say what is going on, but a prodrome of 5 days is really quite long with no lesions at all.  And the chances of getting herpes at a single sexual encounter are not high.  I suggest that you just keep a close eye on things genitally, and in 4 months do another type specific antibody test.  If you can somehow get this other person to be tested (offer to pay for it for sure), then it would ease your mind if he tests negative.  Have you described your concerns to him?

Terri