Herpes Expert Forum
First Breakout?
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Welcome to the Herpes forum. This forum is for questions and support pertaining to herpes simplex virus infections (HSV-1 and 2) and herpes zoster (shingles) and the virus that causes it, varicella zoster virus. Questions about genital herpes are welcome both here and on the STD Forum.

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First Breakout?

Hello Doctor,

I'm a 28 year old heterosexual male that shared a pipe with a female, received oral sex, and had protected vaginal sex all on May 2, 2012. I tested for STDs twice before finally specifically asking for a Herpes test during early August. All results were negative with the exception of HSV-1.

Symptoms (6/12 - Now): Intermittent discomfort under left armpit, small white patch on the lining of my top lip only this week. No genital symptoms.

Questions I'm pleading you would address:

1. Are there different strains of HSV-1?

2. I had a test that provided no numerical result. What test should I request that would provide numerical results, and will numerical results hint on when I was infected even roughly?

3. Will taking antiviral medication affect my body’s ability to create its own immunity to the virus causing dependency on the antiviral drugs?

4. Can HSV-1 contracted genitally make its way on its own through the body to the oral region?

5. Given the time frame of my first noticeable symptoms, can anything be said about the type of strain I have in terms of its strength and frequency of outbreaks it may cause?

6. Does initial infection with HSV-1 cause lymph nodes to swell? Do they occur intermittently?

7. How likely is it to infect someone by performing oral sex if no noticeable lesions are present?

8. Do breakouts change in frequency and intensity with age?

9. Can I share utensils?

10. Should I be worried about HSV Encephalitis?

11. What do you call a Herpes Specialist and how do I go about setting up an appointment with my health care provider to see a specialist?

12. What type of test do you suspect was administered?

13. Given that I’ve never had noticeable swollen lymph nodes and my experience, would you suspect I became infected with HSV-1 through this encounter? If so...

14. Would you lean more towards sharing a pipe or oral sex?

15. Additional advice for treating visible symptoms?

I greatly appreciate your time.

Thank you.
55646_tn?1263664409
I don't believe I've every had someone ask 15 questions, this is a record indeed!

1. Are there different strains of HSV-1?

Yes, there are, but it is unusual for someone to acquire more than one strain of the same type

2. I had a test that provided no numerical result. What test should I request that would provide numerical results, and will numerical results hint on when I was infected even roughly?

There may be numeric results associated with your test, they simply may not have been reported out.  I like the herpeselect ELISA that Quest offers, or the Captia that LabCorp offers, both have numeric results.

3. Will taking antiviral medication affect my body’s ability to create its own immunity to the virus causing dependency on the antiviral drugs?

No, not in the long run, but it will in the short run, and it doesn't really matter, except for testing purposes.

4. Can HSV-1 contracted genitally make its way on its own through the body to the oral region?

No

5. Given the time frame of my first noticeable symptoms, can anything be said about the type of strain I have in terms of its strength and frequency of outbreaks it may cause?

No

6. Does initial infection with HSV-1 cause lymph nodes to swell? Do they occur intermittently?

Sometimes, yes. and yes, for some people

7. How likely is it to infect someone by performing oral sex if no noticeable lesions are present?

We don't have statistics on that question.  I have certainly seen it happen, and in my experience, happen more often than with a cold sore present.  That's probably because most people won't give and most people won't receive oral sex when a cold sore is present.

8. Do breakouts change in frequency and intensity with age?

Most often they decrease in frequency, and for many, intensity as well.

9. Can I share utensils?

there is very little risk in sharing utensils

10. Should I be worried about HSV Encephalitis?

no

11. What do you call a Herpes Specialist and how do I go about setting up an appointment with my health care provider to see a specialist?

Unfortunately, there are very few herpes specialist around.  Where do you live?

12. What type of test do you suspect was administered?

No idea

13. Given that I’ve never had noticeable swollen lymph nodes and my experience, would you suspect I became infected with HSV-1 through this encounter? If so...

I couldn't say.  Lymph nodes can come up for many different reasons, tooth pain, a burned tongue from hot coffee, lots of things.

14. Would you lean more towards sharing a pipe or oral sex?

Again, I really don't even know that you contracted HSV from this encounter!

15. Additional advice for treating visible symptoms?

Visible symptoms, like the white area?

Terri
8 Comments
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Thank you so much for answering all 15 questions! I know it was a lot.

I live in Los Angeles, California. My health care provider is Kaiser Permanente.

The closest specialist I came across was for Infectious Diseases. Should I just schedule an appointment with that type of specialist?

I suppose my main concern was trying to figure out when I acquired HSV-1. Will a numerical result even hint at this?

This is important for my partner and me since we are trying to figure out what changes need to be made in out sex life. Admittedly, we would know if we've always had it if it wasn't for my mistake the night of May 2.

Should we refrain from having oral sex all together? What would you recommend?

Yes, what is your advice for treating visible symptoms such as the barely visible white patch? Is there something else I can use to prevent outbreaks other than antiviral medication that must be taken orally?

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55646_tn?1263664409
I suppose your could schedule an appointment with an ID doc to answer more questions for you.  

No, I seriously doubt that you will be able to know when you got this.  You tested too long long after the encounter to determine if this was a first infection.  

I can't recall, has your partner been tested for hSV 1 as well?  

I wouldn't bother treating a white patch, that really isn't consistent with herpes.  There is nothing we have now to prevent outbreaks except daily therapy.

Terri
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Avatar_n_tn
No, my partner hasn't been tested but I'm pretty sure she has it since I can spot very tiny but present watery blisters on the lining of her top lip.  I describe my visible symptoms as a white patch since it appears that way from a distance, but as tiny watery blisters when looked at closely. Worse yet, I've spotted the same on my three year old son :-(

What do you recommend for treating this? I'm mainly looking for treatment of visible symptoms that won't affect my body's ability to create its own most effective response possible against the virus.

I've read many reviews speaking on the effectiveness of Lysine, do you recommend this?

I will schedule an appointment with my primary care provider since Kaiser advised me that an ID doctor does not see patients regarding HSV-1.
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55646_tn?1263664409
The good science does not show a difference between Lysine and placebo in its effectiveness for treating herpes.  Some people, however, think it helps them.  Are you sure what you are looking at are water blisters?  Most people have a fine line of bumps on their lip.  

Terri
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Avatar_n_tn
Hello Terri,

I wanted to write back after my visiting with my doctor. Surprisingly he revealed that he too has HSV-1 as well as the majority of the population. Although I was somewhat comforted by this, I still worry I might be among those that get frequent outbreaks. Well, I had some final questions I am hoping you can address.

Since I last wrote, I've developed a red bump above the lining of my top lip which has lasted over a month. And two smaller ones with one along the lining of my top lip. None seem to become large and to stage where I can identify individual watery blisters. Possibly because I apply Abreva before bed.

My doctor prescribed Acyclovir, but I'm afraid I haven't started taking the medication. I've read some medication causes the herpes virus to adapt to the medication and can return stronger.

Is this true?

If I start taking medication will I become dependent on it to prevent outbreaks?

My doctor prescribed 200MG capsules 5 times a day for 10 days. The information that came along with the medication states to take the medication for the full course of treatment even if you feel better.

Why do you have to take the full course as if it's antibiotics? Is it for similar reasons for not taking a full course of antibiotics? I'm confused since my doctor said when he feels a cold sore coming on, he "pops a few Acyclovir" stopping the cold sore all together. Is not completing a course of Acyclovir cause the virus to adapt rendering the medication less effective?

If so, do I take a "course" of the medication as prescribed this time every time I feel an outbreak coming on?

You've been of great help to me Terri, Thank You!
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Avatar_n_tn
Correction: Is it for similar reasons for taking a full course of antibiotics?
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55646_tn?1263664409
I think the advice to take the full course is a carrryover from antibiotic messages.   It is not important with herpes medicines.  

If you treat outbreaks, you will not become resistant to the medicines, no.

And anything that stays the same for a month is not at all likely to be herpes.

Terri
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