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BUTTOCK HERPES
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This forum is an un-mediated, patient-to-patient forum for questions and support regarding herpes issues such as: Herpes symptoms and treatments, causes, diagnosis, and herpes in men, tests, telling your spouse or partner.

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BUTTOCK HERPES

DEAR DOCTOR:

I HAVE HSV-2 SINCE I WAS 20. RIGHT NOW I AM 35. CURRENTLY MY HERPES ATTACKS ARE ON MY BUTTOCK AND NOWHERE ELSE. MY QUESTIONSS ARE;
1)
IF MY HERPES ATTACKS ARE ALWAYS LIMITED TO MY BUTTOCK AREA
         AND
IF I DO NOT HAVE ANY SEX DURING AN OUTBREAK (AN ISSUE WHICH I AM TRYING TO BE CAREFUL TO MY BEST)
         AND
IF I USE CONDOMS ALL THE TIME
         AND
IF I DO NOT LET MY BUTTOCK TOUCH MY PARTNERS VAGINA DURING HAVİNG SEX

IS THERE STILL ANY CHANCE OF TRANSMISSION?

2) IF THE ATTACKS ARE LIMITED TO THE BUTTOCK AREA, DURING A PERIOD WITHOUT ANY OUTBREAK, DOES THE ASYMPTOMATIC VIRAL SHEDDING OCCUR FROM THE TIP/SHAFT OF THE PENIS OR FROM THE SPOT THAT HERPES ATTACKS HAPPEN ON THE BUTTOCK?

3) ARE THERE DISCORDANT COUPLES THAT STAY THAT WAY ALL THROUGHOUT THEIR MARRIAGE? OR IS TRANSMISSION INEVITABLE?

REGARDS,

TEOMAN
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13 Comments Post a Comment
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101028_tn?1348750963
This is not the doctor's forum. YOu have to pay to post there.

When you have an ob on your buttocks, you are shedding the virus from the area of the lesion as well as from the entire anogenital area.  In between obvious lesions on the buttocks, the virus still periodically sheds from the anogenital area. The skin on the buttocks is too thick for the virus to penetrate to the surface except for during obvious recurrences.

So yes, even if you are careful about avoiding sex during obvious ob's, you can still potentially transmit the virus in between obvious lesions.  

Has your partner been tested to know their status? Do you take daily suppressive therapy?

Most of the couples I know that are discordant, stay that way as long as the infected couple knows that they are infected.  Any precautions you take above avoiding sex during obvious symptoms, just puts the odds even more in favor of not transmitting the virus.

grace
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Avatar_n_tn
Dear Grace:

Thank you for the answer. My wife is seronegative for HSV-2. Currently I am not taking surpressive therapy. Actually what is dramatic is the fact that since I have OB's on my buttock and exactly on the same spot, I did not tell my wife about the Herpes with the belief that it was enough not to have sex during OB's. We have been sexually active for 5 years. All this time I have avoided having sex with an excuse. However last week I told the truth and now our relation is going into turmoil. I really had not known about asymptomatic shedding if it is any excuse. Anyways...... I still do have some questions/issues though:
1) How do you describe the anogenital area?
2) Does the math below works? (allthough it may be childish)
Male to female transmission for a man that does not have sex during OB's: 10%
Using condoms all the time 10% x 50% = 5%
Surpressive Therapy 5% x 25% = 1.25%
Having attacks on the buttocks 1.25% x 50% = 0.625%

After transmission to the female: female experiencing attacks 0.625% x 75% = 0.50%

P.S.: We have gotten over the first 2 years

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101028_tn?1348750963
I'm sure your wife is a tad irritated at you at this point for not telling her about this until now. don't blame her one bit. How's that couch or are you out in the yard in the doghouse while the dog is sleeping on your side of the bed?

the anogenital area is your penis and anus.

I'm not sure what your math is showing.  On average if you did nothing but avoid sex during obvious genital lesions, her risk is 8-10%/year of contracting hsv2 from you. Suppressive therapy has been shown to reduce her risk by 50% which is 4-5% risk/year. The addition of condoms takes it down to a 2-3% risk of contracting hsv2 from you per year.  Having ob's on your buttocks does nothing to reduce the risk at all. It's no different than if you had lesions on your penis.  

As for if she'd have obvious symptoms if she contracted hsv2 from you, studies have shown that 80% of folks who have hsv2 have symptoms. Only about 20% of folks don't.  The valtrex and reduction in transmission study though did show that if the infected partner was on suppressive therapy, the odds of an asymptomatic infection if they transmit to their uninfected partner are increased ( NEJM jan 1, 2004 ).

Hope that helps clear up some of your questions. keep asking them as you have them :)

grace
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Avatar_n_tn
Dear Grace:

Believe me it is dark and cold out there. And the dogs are not friendly in my neighborhood :-) I am not sure where we will go from here but we have a kid and I foresee no good end to our relations as I know her. Anyway I still have questions if you dont mind:

1) "The valtrex and reduction in transmission study though did show that if the infected partner was on suppressive therapy, the odds of an asymptomatic infection if they transmit to their uninfected partner are increased ( NEJM jan 1, 2004 )."

So what you say is while on suppressive therapy, my body will kind of weaken the virus before I give it to my spouse? I always thought the other way around just due to the fact that virus may gain some immunity to antivirals.

2) Do you have any info regarding viragel as to when it may hit the market? Would you bet your hopes on this?

Teo

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101028_tn?1348750963
the virus doesn't become resistant to valtrex over time with use. The rate of tk deletion is still the same as it was 20+ years ago before acyclovir was used to treat herpes - less than 1% in otherwise healthy folks.  

Did you mean vivagel?  No idea when and if it will make it to market. Most of the antimicrobial gels are failing/have failed in testing in humans.  I haven't seen any published updates on vivagel recently.

grace
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Avatar_n_tn
"In studies of transmission of genital Herpes in couples, the annual risk of transmission averaged 5 to 10% per year for those abstaining from sex during outbreaks.  The risk of acquisition was much higher (16.9%) for women, but somewhat lower for those who already had HSV-1.  There is some evidence that people who have HSV-1 are more resistant to the HSV-2.  This should not be interpreted as immunity but rather as a higher resistance factor."

Grace my wife is psitive for HSV-1. Do you agree with the above?
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101028_tn?1348750963
This has been debated quite frequently in the journals. Some studies show that hsv1 provides some protection while others show no significant protection at all. The biggest argument against it helping much at all is that in the populations with the highest hsv2 infections, they also have the highest hsv1 infections too.  

What we do know for sure is that having hsv1 first helps to take the edge off of a newly acquired hsv2 infection so to speak. Typically makes it milder and not that "classic" humdinger of a first ob that keeps you miserable for a few weeks.

grace
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Avatar_n_tn
Dear Grace: Once again sorry for the disturbance, however I really appreciate your help. I have couple of questions:
1) Transmission Redusction Therapy
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Avatar_n_tn
Dear Grace: Once again sorry for the disturbance, however I really appreciate your help. I have couple of questions:
1) Transmission Reduction Therapy
a) What medication and at what dose and for how many years?
b) What are the long-term side effects (kidney, liver)?
c) What is the percentage reduction in transmission
d) Would you go with TRT if you only have 1-2 outbreaks a year? I am + and my wife is -. She is right now destroyed with the news emotionally.
2) Is there a a change in any blood value, chemical, hormone during viral shedding that may lead to an early warning system?
3) Do you expect a cure any time soon?
4) Do you expect a perfect (100%) transmission reducing agent/medication any time soon?
5) Can you send me a link that has some sort of demonstration of viral shedding.
6) In one of your earlier posts you said "As for if she'd have obvious symptoms if she contracted hsv2 from you, studies have shown that 80% of folks who have hsv2 have symptoms". In many sources it says 75% of the people do not have they have GH!?

If you can't answer all of these questions that's fine.
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Avatar_n_tn
HEY I HAVE A QUETION FOR YOU DO U HAVE A SCAR WERE U GET UR OUT BREAKS IF SO DOES IT LOOK LIGHT PINK DARK BROWN OR DO U EVEN GET SCARS DO U GET UR OUTBREAKS ON THE SAME EXSACT SPOT EVERYSINGLE TIME
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Avatar_n_tn
hi there. I do not have any scar once the attack is over. For example the healthy fresh skin is there as of today. However the attack has been on the same spot since for ever.
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Avatar_n_tn
Dear Grace. I have still more questions:
7) Crazy as it may sound; would it work if I tried to put on a latex based waist outfit that covers the entire genital area. Of course there will be an opening and this outfit will be accompanied by a condom. At this point I do not care about the emotional side of love making as you can see. I am just trying to get to 100% or 99.9999% accuracy in blocking transmission. (Same concept can be materialized may be by a spray that creates a layer right on the skin to avoid any skin-to-skin contact.)
8) Would it be some sort of risk reducing action to take a shower with a body shampoo everytime before I have sex with my wife?
9) What is the chemical/molecular composition of viral shedding when compared to the liquids inside the blister?
10) This is not a question. Just a comment: The enemy is there. The enemy is exhibiting exactly the same type of behavior every time. This is a very weak side of any opponent in nature. So I am having hard time understanding why it is taking forever to model its behavior and find a cure. Although I know about the immune system, hiding in sacral ganglion, etc etc it looks like scientists are not looking very closely for evidences in the body.

Regards,

Teo



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Avatar_n_tn
hey thank you see its because i had sex with a girl and i seen a pink scar on her butt cheek and their was a scar  on it it looked verrry light pink and i got really scared
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