HSV 1 +

[Needhelp4825]

Hi doctor. Back in January of this year, I started getting flu like symptoms. I had high fevers for a week, and was very tired. I went to the de and he just said I had some kind of virus. Two days later I started feeling uncomfortable "down there" and thought I was getting a yeast infection. I bought some vagisil and it seemed to not help very much. I developed some blisters. I don't remember having a discharge. I ended up going to the ER on January 27th. They immediately told me that I had herpes. She came back and told me that I had gotten mono. My immune system was very low and I was very weak.  My boyfriend at the time was the only guy I have ever been with and he said he was clean, however he could be lying. Need to say, three months after my last encounter with him, I got a type specific igg blood test. It came back positive for HSV 1 and negative for HSV 2. I knew it would be hSV 1 positive because I've had fever blisters on my mouth in the past. SOOO....my question is, how did I get this? Did I get it from receiving oral from him and he might of had a fever blister at the time? I don't remember. At the same time I was in the ER, I had a fever blister on my own mouth and down there I guess as well. Is that possible? Could I of gotten it from touching the cold sore on my mouth and then accidentally touching myself down there or did I get this from my bf at the time? Like I said, I also had mono and was wiped out. My other question is, does this mean I have genital herpes? I need to know exactly what is going on so I can notify any new partners if they are at risk. Please help me.

[Terri Warren, RN, Adult Nurse Practitioner]

Isolated says nothing about the type, only that it is positive.  Too bad they didn't do the next step and type the virus.

Terri

[Needhelp4825]

Yes that makes sense. They did do a swab test when I was in the ER and I posted my results in my photos. It says isolated?

[Terri Warren, RN, Adult Nurse Practitioner]

My concern about you taking the Valtrex daily from the time you were first diagnosed is that it can prevent antibody formation for a long time.  We now have a patient who has taken Valtrex for 18 months, since her first diagnosis, swab test positive for HSV 2, and she has not yet had a positive antibody test.  My advice would be to stop taking the antiviral completely.  If you have another outbreak, have a swab test and be CERTAIN it is typed.  If you have not outbreak during the next three months, get another type specific antibody test.  You could have HSV 2 and not know it, due to the antivirals.  The purpose of antiviral medicine is to prevent viral replication.  However, if there is little or no virus made, the body can't make antibody in response.  Does that make sense?

Terri

[Needhelp4825]

Did did a swab but they didn't type it. All it said was isolated. My cold sores in the past have either been on my upper or lower lip. I started feeling some tingling in my neck and they pop up a few days later. They last about a week. Yes, I have been taking Valtrex 1gm once a day every since they told me I had herpes when I went to the ER.

[Terri Warren, RN, Adult Nurse Practitioner]

Did you have a positive swab test for herpes from your ER visit?  
Can you tell me about the cold sores you've had in the past?  Where, how long they last, how they look?
Have you taken antiviral therapy during this three month period away from your boyfriend?

Terri