HSV 1 & HSV 2

[dreams2014]

4 years ago I had sex with a condom and he performed oral sex on me. Within 2 weeks I had vaginal pain on my inner labia - a long white looking lesion going down one side of my inner labia.  It never blistered. The gyno thought I had a yeast infection, not HSV and I got a neg viral culture too. Also neg blood work for HSV 1 & 2. The next few months, I was sick - malaise, fever, body rash, meningitis like symptoms, strange vision etc  I later tested positive for HSV 1, which I'm confident I got from that encounter. My vagina felt better within a few weeks, while the viral sypmtoms lasted a few months.  Eventually I totally recovered and have not had vaginal sypmtoms since.
1) Is it possible they only swabbed for HSV2 so I got a neg result?
2) Since the doctor and the swab both said neg for GHSV – do I need to inform partners?  I do have HSV 1, but it seems inconclusive to what kind I have, even though I feel ‘intuitively’ I acquired it genitally.

14 months ago I had unprotected sex 3 times in 1 night. Within 2 weeks, I had a small rash on my left buttock.  Red, no blister, sloughy skin. Gyno thought maybe herpes, but said no when I said there was no blister.  I also had strong viral aches in my left leg and sacral tingling, which lasted a few months.  Eventually it faded, to this day I have aches or sensations in my left buttock and leg down that I never had before incident. No other sickness and no skin rash since. A month after the incident I had unprotected sex with my new bf, he got rash on head of penis - no blistering, itching or malaise, just small flat red spots.  He is uncircumsized .I got blood tested 18+ weeks after at Planned Parenthood for HSV 2 and was negative.

1)  Is PP a reliable place?  Can it take up to 6 months to make antibodies?  I was only at 4.5 months - Do I need to get retested?

2) My partner’s rash could have been?

3)  Could I have contracted another virus that caused the symptoms I listed above?

Thank you!

[dreams2014]

Thank you - can you please send me just a link to Rhodo Morrow's article?  I can't find it online.  I've been looking.  

Thanks for your help!

[Terri Warren, RN, Adult Nurse Practitioner]

I didn't refer to any study with 83% accuracy by six months, I believe you said that.

This is my final post on this thread.

Terri

[dreams2014]

Ok thank you.  Since I've had no other rashes and just some aching in that buttock , then it would be unlikely that it is HSV 2?  I've read that acquiring this from 3 exposures in 24 hr period would be unlikely?  

Which study are you referring to, with 83% accuracy by month 6?  Or a different one?  Your book said 16 weeks virtually all will have antibodies?

Thanks for your final answers, just want to put this to rest!

[Terri Warren, RN, Adult Nurse Practitioner]

We know that people in African countries have a different response to the antibody tests than people in the US.  I prefer to use Rhoda Morrow's article about seroconversion as my guideline.  

As for the little rash on your butt, it certainly could have been an HSV 1 recurrence starting that didn't happen.  Guess you will never know the answer to that.

My personal opinion is that your test at 18 weeks is adequate.  This is a somewhat inexact science but at some point, you have to believe a negative and decide that you've done what you can.  Will there be exceptions?  Probably, because there are exceptions to every rule.  But can you live like the exceptions are your new reality?  I wouldn't.  

Terri

[dreams2014]

I'm sure you are familiar, but this study seems very positive at 77% positive at 14 days who are HSV 1 positive:  

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446869/

better than the other study I read.  I did also read a portion of your book stating 16 weeks as conclusive.  Just trying to cover all my bases!

Thank you!!!

[dreams2014]

Thank you Terri! I agree with you that I acquired Type 1 during that incident.

I am however much more concerned now with the second incident, in which I had unprotected sex three times and developed a rash on my left buttock with sacral tingling and leg tingling.  

In the past year and a half I've not had any subsequent skin symptoms or vaginal symptoms.  I have however had persistant aches or sensations in my left leg on and off. No tingling, itching or burning though.   The person I was with claimed to test negative for hsv 1 & 2 about 4 months after our encounter.  I tested negative for 2, 4.5 months after our encounter.  I can't get it out of my mind because of my strange symptoms.  I was tested via PPH and called today and was told it was IGG through LabCorp.  So I'm assuming the Capita test?  This is very accurate?  

I have a new partner and plan on using condoms, I'm not on birth control anyway.  I just don't think I can handle the stress after 6 months thinking I had hsv 2 and then a year thinking I'm ok again.  18 weeks & 5 days post a single evening of exposure should be fairly good?  Especially since he claims to be clean.  

I did read the study in which on 83% seroconverted by 6 mos with previous HSV 1 infection, but it is 10 years old - are tests more sensitive now? And small sample 26 people!  Plus I had atypical symptoms and mild if any, I thought late seroconverted usually had a more intense set of symptoms?

I may be able to get HSV 1 numbers from doc office, but may take some time.

Thank you both!!!!!

[Terri Warren, RN, Adult Nurse Practitioner]

Dr. Hook and I have actually been talking about your case and there is some uncertainty here.  You may just want to leave this alone, and if you do, and assume you have HSV 1 genitally, that is certainly one strategy that would work and one that may be the best way to handle this.  On the other hand, I would sure like to know what the numeric value associated with your hSV 1 positive antibody test.  Can you get a copy?  Or did it just say positive or negative, do you know?  If the value is less than 3.5, it would be good to confirm that.  Also, I think it would be important for any new partners to be tested for herpes.  If they are positive for HSV 1, the likelihood they would be infected genitally is extremely low.  But there is always the possibility that they could be HSV 2 positive, in which case it would be good for you to know that so you could take measures, as a couple, to reduce the risk of transmission.  

If I had to bet money on this case, I would bet that you acquired new HSV 1 infection because your antibody test went from negative to positive during a brief time period, which normally indicates new infection.  But we need a little more info to confirm that.

Terri

[dreams2014]

HI Terri,

Here is the link to the thread with Dr. Hook if you are interested:

http://www.medhelp.org/posts/STDs/HSV-1--2/show/2087270

[dreams2014]

HI Terri,

After the first encounter above I went from neg for both HSV 1 & 2 in a blood test to positive for HSV 1 and negative for HSV 2.  I don't quite recall how much later I got the second blood test, I'm sure it was probably after 3 months or so.  A decent window.  I had a swab that was swabbed on the lesion and it tested negative for HSV - this was at my gyno's office. She also didn't think it looked like HSV and treated me for a yeast infection, but as I mentioned above I had a lot of other symptoms of feeling sick.

The second incident I describe above that happened a year and a half ago about.  I had unprotected sex 3 times in the course of a night with someone.  Then within two weeks had this slight itch on my bottom and just about the size of two quarters.  I had a visual exam by my GP who didn't think it was herpes at all - he said foliculitus.  And then my gyno, thought it could be herpes, but when I said there was no blister she said no.  I had very distintive sacral tingling and viral feeling in my left leg that went on and off for a few months - maybe 2 or so.  

I told the person I slept with that I thought he had given me HSV 2 - he was shocked.  He had a blood test about 16 weeks after we were together and he told me he was neg for both HSV 1 & 2.  So at this time I went to get the blood test and that was at almost 19 weeks and I was neg for HSV 2.  They only tested for HSV 2 at that time.  (I already knew I had tested positive for HSV 1 before anyway).  There is no reason this person would lie to me for being negative for both HSV 1 & 2 and when I went ahead and tested negative too at 19 weeks I really thought I was in the clear. I can be kind of paranoid.

I have never had any other rash since that one or any vaginal symptoms at all.  I still have a slight ache or sensation in my left buttock on occasion or my legs. It kind of comes and goes but seems to be around often.  It could be something else?  

I've put the whole thing to rest with much relief the past year and half,but I'm starting a new relationship and started wanting to read about GHSV1 possivle transimmsion.  Since that first event it was never conclusive if it was really a genital transmission or not.  From everything I've read I've stopped being too worried about being able to give him HSV 1 genitally.  However, as I was reading I saw that it can take 6 mos for some people to develop antibodies for HSV 2.  I got really scared.  I really want to put this all behind me and relax and use condoms, but if it gets very serious perhaps we won't use condoms eventually.  I just don't know what to do, but the thought of getting tested again is really scary.  I really thought I did well at 19 weeks being negative (this was the test at PP, which I'm assuming is IGG).  Please let me know your thoughts.

[Terri Warren, RN, Adult Nurse Practitioner]

Planned Parenthood is a reliable place to have testing done, but the question is really how accurate is the test.  The place drawing it doesn't make that much difference.  However, you don't indicate if you were tested for HSV 1 as well as HSV 2 at PP.

So I need to clarify just a bit with you.  So you had this encounter, within 2 weeks you had this long white ulcer, then you tested negative for HSV 1 and 2, with a negative culture from the lesion.  You later tested positive for antibody to HSV 1 and 2, so you went from negative right when you had the lesion to positive later, is that right?  How long after?  Do you recall?  

Did anyone look at the buttocks lesion?

Terri

To me, if all of this is correct, it sounds like you had new HSV 1 infection.  You went from having no HSV 1 antibody to having antibody which, to me, suggests that you acquired new infection.  

[dreams2014]

Dr hook also answered  in STD forum, but wanted your opinion too.