Could this be a recurrence or a primary episode as a result of recent exposure?

[krissy6799]

I would like your informed opinion if my OB was the 1st time I was exposed or a recurrence + how likely is it to get genital HSV1 from genital contact as opposed to oral?
I developed really severe symptoms (swollen glands, fatigue, aches, blisters all over my genital area ) within a week of contact with my then boyfriend (15weeks since previous partner).  Swab was +ve HSV1, boyfriedn's swab was -ve. IgG blood test 2 weeks after sexual contact (15/16 weeks after previous partner) was negae, repeat test  +ve 11 weeks later. (Don't know about boyfriend 11 week test as we split up). Could aciclovir prescribed at the time of the outbreak affect the test resulty -  I had been taking them for 3 days before blood test. My boyfriend never had cold sore and had been in a long term relationship before me. Previous partner did suffer from cold sore and had 1 a few days after sexual contact.
When I started with symptoms , I applied hydrocortisone daily (not realising it was HSV1) but stopped as soon as the ulcers started to appear. Could the hydrocortisone have caused a recurrence to look like first exposure rather than recurrence? (The doctor considered it was a primary infection). I have had a few outbreaks since and they have been much milder.
I am left with the conclusion that I could have contracted the virus from the boyfriend at the time, rather than the previous partner and now I feel I need to speak to him to let him know so he can be re-tested before he starts to see someone else. (I have already asked him to get tested 16 weeks post contact with me)  as I don’t want him to pass this on to anyone else.
I know it doesn‘t matter who gave me it, but it would help me get some kind of closure if I had some feedback.
Thanks in advance for your response.

[Terri Warren, RN, Adult Nurse Practitioner]

You really need to start your own new post at the website, rather than tacking on to someone else's post with an entirely new situation.  Would that work for you?

Terri

[lou7979]

Terri, I recently bought your book on Amazon.com, can't wait to read it.  I'm a 30yr old male who was recently diagnosed with HSV-2 and this is still all new to me.  Here's my question-- Reading from the original post, can I assume that recurrent symptoms usually are milder in comparison to the first exposure?  And does everyone with genital herpes have to go through a first exposure stage or can they just have recurrences?  Because my symptoms have been extremely mild and I believe I've had the infection for at least a year because thats when I began to feel a little bit of itching.  But I can't say that I've ever had a sore or a strong outbreak except those couple of times of very mild itching.  So is it possible that I never had a first exposure outbreak and I'm just going to have recurrences from now on like the couple of times I've experienced those mild symptoms?  Thanks.

-Lou

[krissy6799]

Thank you so much Terri - you have been a great help. Hopefully this post may help others too.

[Terri Warren, RN, Adult Nurse Practitioner]

The stick in the penis is not a test for herpes, that's for chlamydia and gonorrhea, I think, although a very old style way of testing, to be sure.  Now most everyone just uses urine.  

I'm glad this clarifies for you.  My guess is that he didn't know he had herpes and gave it to you.  I'm not sure about the testing, but he may have assumed that the "stick" tested for everything, including herpes?  

Your task now, I believe, is moving on and making this adjustment to having a kind of genital herpes that recurs infrequently and is less likely to infect others.  My best to you in this task!

Terri
author of "The Good News about the Bad News" available on Amazon.com

[krissy6799]

Thanks Terri.

Thinking back, he described a test where a 'stick' was placed down his penis - maybe they decided to do a full screen for everything. I honestly don't think he would have exposed me knowingly, but it's looking like he definitely passed it to me.
Thank you for your help - I have been sending myself crazy playing this out in my head and you have helped me to clarify the situation.

[Terri Warren, RN, Adult Nurse Practitioner]

I doubt that your test was wrong since you eventually did become positive - if you were going to be positive, I think you would have at the beginning.  

If he had a swab done, then it had to be from something, some kind of skin lesion.  I don't believe anyone would swab normal looking skin.  

Terri

[krissy6799]

Thanks again Terri. I never saw his test results. He went to be checked after I was showing symptoms. I'm pretty certain he had a swab done and if I remember rightly he had a blood test (it was last July when all this happened). I suspect the clinics in the UK don't do the blood test routinely (they rely on the swabs unless there is a strong indication of herpes - eg patient/partner showing symptoms). I had to really push for a 2nd test. I doubt they suggested my boyfriend should be tested 16 weeks post-exposure, whoich is why I asked him to go himself. This approach is ludicrous - no wonder herpes is so common(just my personal opinion).
If his HSV1 result was wrong, then couldn't my initial test have been? ie I could have been positive prior to contact with my boyfriend? This is why I am so interested in the relevance of the other generalised symptoms as an indicator to primary infection. At the time, I accepted that my previous partner was the source due to him having cold sores. Also, I have had more sexual partners than the boyfriend. This is frustrating me now as I feel my boyfriend (now ex) needs to be told that this may not be the case.
Thanks again.

[Terri Warren, RN, Adult Nurse Practitioner]

There are lots of posibilties here.  One is that he was newly infected.  Another is that he's lying about the test results (unless you saw them).  Another is that the IgG test for HSV 1 misses one out of every 10 infections, so the test could have missed his HSV 1 infection.  

The reason I asked about lesions is that you said his swab test was negative in the post above.  Why would he have had a swab test without lesions?  Maybe you meant blood test?

terri

[krissy6799]

Thanks Terri

As far as I am aware he didn't have lesions. I don't know if I made it clear in the original e-mail that his 2week IgG blood test was negative, so this means he must have caught it in the 12weeks pre-test - is that right? (Assuming accurate test of course). Lots of people on the forums suggest the blood tests are often inaccurate so I was wary of accepting the results; would you agree the severity of the symptoms alone indicates a primary infection?
Thanks

[Terri Warren, RN, Adult Nurse Practitioner]

I agree with your doctor that this was a primary outbreak.  A positive swab test combined with a negative blood antibody test for the same type indicates that there was virus present on your skin and but enough time had passed to make antibody.  The hydrocortisone may have made the outbreak worse but wouldn't change a first outbreaks into a recurrence.  I believe you contracted it from your boyfriend who may not have been aware that he was infected.  Good luck with getting him tested and trying to get him to tell others.  He doesn't seem ready to deal with this topic, though I could be mistaken.  so he had genital lesions?  HSV 1 can certainly be transmitted via intercourse, though that occurs less often than HSV 2 transmission via intercourse.

Terri