BV or Herpes?

Exposed 9.5 weeks ago to HSV2. Partner did not know they had, have always been asymptomatic, never any signs. Tested positive once they had the test done. Has probably had for years and did not know.
A few days after started with irritation and redness and had a small tear at entrance to vagina. Had std panel of STD's at 2.5 weeks, all negative.
Had herpes blood test at 2.5, 6, and 9 weeks all negative. Another std panel at 6 weeks, negative but diagnosed with bacteria. Took 4 weeks to get rid of bacteria and probably have had right from the beginning. Never any sores or lesions and still do not. Have a persistant irritation on my clitoris that will not go away. Doctor thinks could be from the bacteria.
What hare chances of having HSV2? I have had HSV1 since childhood. Could the irritation on my clitoris be from HSV1 or 2? Should I get another blood test at 12 weeks?

[Terri Warren, RN, Adult Nurse Practitioner]

did you just have a single encounter with the person who had HSV 2?  If yes, then the chances of you acquiring HSV 2 at a single encounter are very low.  Since you have had HSV 1 most of your life, I would encourage another antibody test at 16 weeks.  The tear worries me a little.

The bacterial vaginosis is not related to herpes specifically, but may facilitate entry of the herpes virus into the body, difficult to know for certain.

Terri

[Rainy12]

Yes, it was just one encounter. As I said, he never had any previous symptoms. The tear has healed and right now I just experience some " twitches" and the irritated clitoris. If it was herpes would you think I would have broke out by now with all the irritation I had? It seems bacterial infections and herpes have some similar symptoms, and also as I said,this irritation has been going on for about 8 weeks. The lab that did the blood test states their results are 97% accurate at 6 weeks. Is that a true statement? Also, could the irritation in the clitoris be a herpes sore that never really broke out? Thank you

[Terri Warren, RN, Adult Nurse Practitioner]

No, BV and herpes do not have similar symptoms.  
And I would very much disagree with the lab timing they gave you.  It does not fit with the research.  The research is that at 3 weeks, 50% of those who are going to test positive do so, at 6 weeks, 70% and by 4 months, most everyone.  

No, herpes symptoms don't last for 8 weeks.  And normally, BV doesn't cause irritation such as you describe.  It causes odorous discharge and occasionally irritation, but not very often.

Terri

[Rainy12]

Thank you for your help. The bv I had was a white discharge but no odor. Just the redness and irritation. I will get another blood test to be sure. The doctor feels that the irritation on the clitoris could be from the bv, I was worried it could be a herpes sore, but it never opened or blistered. Looks more like skin irritation. Your thoughts? Thank you so much!

[Terri Warren, RN, Adult Nurse Practitioner]

The reason it is called bacterial vaginosis instead of bacterial vaginitis is that "itis" implies inflammation  where "osis" does not.  That's why it is unusual for BV to cause the kind of symptoms that you describe.  The odor is usually classic.  On the other hand, some bacterial infection and certainly yeast can cause irritation and redness.  You might wonder if another opinion would be useful.  But it certainly doesn't sound like herpes.

Terri

[Rainy12]

Thank you Terri, the just told me it was a bacterial infection. What is the most troublesome right now is the irritation on my "c". Does not look like a blister, the skin is raw looking and looks like it is slight raised. It shoots pain now and then and sometimes just aches. I was worried the herpes settled there and that a sore never broke out. I guess it is still possible I could break out with sores. As you said even though 3 negative tests it is still possible they could be wrong. I do appreciate your help.

[Rainy12]

It's been a while since this post, if I need to pay again let me know. Here is where I am. Last blood test at 16 weeks post exposure came in at equivocal, 1.08. I am now very confused. I still have redness and irritation at vaginal entrance, almost everyday for the past 3.5 months, never any lesions. Doctor swabbed the sore area for herpes 2 weeks ago, came back negative. My clitoris is still occasionally itchy. I tested positive for BV 3 times in 3 months, last culture done 2 weeks ago was negative. Do you think this could still be herpes? I have read where having herpes can cause vaginitis symptoms. When I questioned my Gyno she said she never heard of that but then again she told me I would not get herpes unless my partner had OB going on which contradicts everything I have read so I question her knowledge. It does burn at the entrance where the redness is and the skin is very raw, she prescribed steroid ointment and when I told her about the blood test she told me to retest in a month. She did not seem to know much about herpes. I have HSV1 since childhood so I am wondering since the last test is now equivocal if that delayed seroconversion and it will now be positive . I value everyone's knowledge on this site and would appreciate your thoughts. Again, if I have to pay again let me know. Thank you

[Terri Warren, RN, Adult Nurse Practitioner]

How frustrating for you!

Your doctor does not agree with traditional herpes wisdom on some points.
If you want clarification, you could get a western blot.  Enough time has gone by.  I honestly don't think that herpes would continue to cause you irritation for 3.5 months

Terri

[Rainy12]

Thank you, I think I read on here that you can provide information on the Western blot test, correct? Or would you wait the month for another IGG? I'm afraid my Gyno would not know about this. Do you think the HSV1 caused a delay and do you think the itchy clitoris could be herpes? When you google itchy clitoris herpes comes up as a possibility. Sometimes I feel a tingly feeling going on but could be my mind playing tricks as I feel certain I have it. Thank you again

[Rainy12]

Sorry, one other question I forgot to mention in last post. Is it a sign that first three tests negative with no values listed but know they were under .91 and last test comes in at 1.08?

[Terri Warren, RN, Adult Nurse Practitioner]

Not really, I don't think the lab test differences are likely significant since you've waited long enough for testing and haven't reportedly taken any long courses of antiviral therapy.  We don't know how different this 1.08 result is from your previous tests, honestly, since no value was reported.  

I wouldn't repeat the IGG again, no, I think you'll likely get similar results.  Your next test should be definitive.  You can order a herpes western blot test kit from UWashington to have your own provider draw your blood and send it back to them or we can order it for you from the clinic.  You would need to become a phone patient of ours which is pretty easy and not very expensive.  Either way, you need this better test, I believe.

I had to laugh out loud when I saw that you had googled itchy clitoris.  It makes sense, of course, but is still kind of funny ;-)

Terri

[Rainy12]

Hi, my email showed a response to my above post but when I open the post it is not there. The response was from yesterday and started with" not really, I don't think the lab test differences" . Could you repost if this was your response please. Thank you so much

[Rainy12]

I was now able to view the response, thank you.
What is the cost to do the WB request from your clinic? Can you give me the # to call so I can find out about the procedure?
Do you think now ( 17 weeks) is enough time to do the Western Blot?
I did take a short term dose of Alvycor ( not sure of spelling) when i first found out i was exposed, that was back at the end of January and I was on it for 7 days ( 2 pills per day).
That was the last time I took it.
Speaking of itchy clitoris, have you heard of that symptom before from anyonw who has herpes?
Thank you for all your help....

[Terri Warren, RN, Adult Nurse Practitioner]

We don't participate in the cost part, we ask that people handle that directly with the Quest lab.  Seventeen weeks is long enough to wait to be tested, yes.  Seven days of acyclovir will not impact the testing.  

For contact info, westoverheights.com

Herpes can be itchy, yes, but so can lots of other things.

Terri

[Rainy12]

Thank you again, you are all so wonderful there to help us people who are going thru this anxiety.

[Rainy12]

I just have to ask this. I have also been corresponding with Grace, ( you are both truly wonderful, do not know what I would do without you.) grace feels this is not herpes, she recommends no more testing. She feels the equivocal at 16 weeks is negative. I am just so scared because I never had any problems down there before this encounter. I felt discomfort the next day and I worry about the original small tear that was found. Since partner had but never knew because he was asymptomatic and it only was one time. What are your feelings on that I could truly have herpes? I am scared it could be the underlying cause of why my irritation will not go away. I am going to family doc today for anxiety meds as that is how worked up I am about this. I do have a regular partner and am in a relationship so I want to be sure of everything. Thank you again

[Jj258055]

Are biopsys an incorrect way to test for a first time herpe check? Bc if someone tested pos for hsv1 but they had a biopsy of tissue then wouldn't blood be the positiveness of the test? Wouldn't a lesion be more accurate to see if it were hsv1 in genitals?

[Terri Warren, RN, Adult Nurse Practitioner]

I agree that this is very unlikely to be herpes.  However, I also find that people who have sort of iffy results have a very hard time letting go of the issue and moving on until they get something more firm.  If you can succeed and letting this go without a confirmatory test, then that's fine.  I just don't think this is as firm as you might like it to be.  Is it?

Terri

[Rainy12]

Hi Terry,
You're correct, if last test would have been negative I would not question this or if my symptoms would go away but I still have this consistant irritation. I saw my 3rd gyno today and I told her I was using this steroid ointment for the raw skin and now it is more red and irritated then before. She said if this was herpes showing just irritation that mixing it with the steroid ointment is not good. Also, it could just be a reaction to the steroid ointment. I just can't win! I am more sore down there now then I have been in a while...
I went to my primary care doctor yesterday and he was very helpful, he knew alot about herpes and his knowledge was everything I have read on here.
He told me his thoughts were if I had another IGG test that the results would probably be near the same range as before and even if it gave me say a 1.15 which would be considered positive, that is still so low that it is questionable. He did mention his thoughts on the IGG tests are that they are very sensitive nowadays and he thinks the results at this 16 week point should be true. I asked him about WB and he said he would write me a script to get it but when I called Quest they told me they do not perform this for herpes, their WB is for Lyme disease. So now I am confused as to how to go about this. I am going to research but I saw a site about taking the sample to fed ex and shipping yourself once you get the kit from UW but it was dated 1999 so not sure if that is true any longer.
Again, I so much appreciate your help, I cannot thank you enough.

[Terri Warren, RN, Adult Nurse Practitioner]

Right now, I'm the only person in the US who can order the HSV western blot.  You could also send directly to UW for a kit, that is correct.  If you want me to order it, you need become a phone patient of the clinic.

I'm hopeful that Quest will reinstate western blot availability, but not right now.

Terri