Herpes 2 Question

[Jazzman1950]

3 months ago I had sex with woman.with condom.  A few days later I developed a very itchy red patch where the shaft of the penis meets the pubis. I went to a dermatologist who said I had HPV. Did cryosurgery. The area healed. No reoccurence of red patch.  Testicles got fiery red and itchy and my anus began to itch.  I went to a dermatologist who said I had "jock itch" and prescribed Desonide .05%, clotrimazole 1% and 7 days on Diflucan.  Due to itching pubis and anus, went to Urologist who did a DNA swab test on itchy flesh-colored bump on the pubis and area of the pubis near the shaft.  The result was negative for HPV but positive for Herpes 2.  Tested  neg for HIV, Chlamydia, Gonn., and Syph.  An ID Dr. said that he considered the DNA test to be conclusive but said I was dormant. I asked him if I were dormant, why I was still itching in the places I have described.  He said fungal.  Right now, my symptoms are itchy pubic area, itchy anus and testicles.. So I have several questions: 1) Even though I wore a condom, I know that some of this woman's vaginal fluid touched my pubic area.  I don't remember her pubis touching her genitals but that is certainly possible even though I wore a condom. Can Herpes 2 be transmitted this easily?; 2) Do you know if a DNA swab test is conclusive diagnosis of Herpes 2?  Any chance of a false positive? 3) Should I have a blood test and, if so, which blood test by which laboratory?  4) Are the symptoms I have described consistent with a diagnosis of Herpes 2 or do they suggest a specific type of herpes or other disease? 5) could the itching  be related to Herpes or is it more likely related to something else? 6) The ID Dr. said I did not need anti-viral medication because I do not have any active lesions. But why am I itching?  Could the itching be a sign of "active" infection?  ID Dr. says this is not possible. Do u agree? 7) Do you have any suggestions as to who I could see or where I could go to get proper treatment for this?  

[Terri Warren, RN, Adult Nurse Practitioner]

At least you have clarity.
In terms of the psychological issues:  I strongly suggest that you try to read the chapter in my book about psychological adjustment and read it again until you have worked on yourself about this issue.  These are not feelings that you need to feel, but if you have improper beliefs about your infection, then you may well have feelings that aren't helpful.  

This will be the last post on this thread.

Terri

[Jazzman1950]

Thanks. I know you have many questions to address.  I got a copy of the DNA lab report/  It was faxed to the dr and is illegible.  But I can make out that it says pos for HSV II.  I have called the docotr's nurse and asked her to please obtain for me a legible copy because I acn see that there is more info on the report that is illegible.  Needless to say, this whole thing has exhausted  me buried me in shame, depression and fear.

[Terri Warren, RN, Adult Nurse Practitioner]

You don't have to have anal sex to get herpes outbreaks around the anus.  The virus can travel along that particular nerve to get to the surface of the skin.  The Herpeselect is fine for looking for herpes antibody.  But do get a copy of that lab test and confirm what it says, OK?  

I'm not going to respond more to this thread until you get your biopsy and antibody test results back.

Terri

[Jazzman1950]

I forgot to say that the new dermatologist said I should continue using Desonide on testicles  She didn't think it was fungal.  She looked at my rectum and said she saw no signs of herpes but she said that  that the tissue was red.   She asked if I drank a lot of coffee and I told her "no."  I told her that I had been scrubbing it a lot.  She said that might account for it looking aggravated.   The uro I went to asked me if I had had anal sex and , of course, the answer to that is "no."   I do have a friend who takes Lexapro as I have been taking recently.  Coincidentally, he told me that his rectum itches also since he started.  I don't know. Maybe he has herpes too!!  

[Jazzman1950]

I just glanced at it.  It said

HPV--Negative
Herpes II- Positive

I guess I should get a copy to study it further.  It was just very cut and dried like I have described above.  It took 3 weeks to get the results and I don't know the name of the lab.  I'm going to go get a copy of it now.

Will get biopsy results in about 10 days.

I'm going to get the blood drawn today.  I asked the uro about a western blot test and he said that really blood testing is unnecessary because it will not tell me anything we do not already know. But he gave me a requisition for blood test, I suppose, to give me another few days to wish it weren't so. But I know what I have. Apparently both HPV and HVS II.  Looking at the requisition form, he has checked  "HSV 1 & 2 IgG, Herpeselect."  Is that a good test or is there a lab I could call and get another test that you would recommend?  Thanks for your patience.

[Terri Warren, RN, Adult Nurse Practitioner]

I can see how all of this is confusing for you.  You've had a positive HSV 2 swab test.  If you were my patient, I would tell you that you had genital herpes, whether the current symptoms that you were experiencing were herpes or not.  When is the biopsy due back?  Have you actually seen a copy of the results of the swab test that says you have HSV 2?  Have you had a herpes blood test done yet?
Terri

[Jazzman1950]

Can't contact her. I am just despondent. Just came back from 3rd dermatologist. She said the rash I described doesn't "sound like" HSV II.  She said that it usually presents as "blisters" or "vesicles." She also said that she would be surprised if I had gotten it from this one act of protected sex and more likely got it from unprotected sex I had with my previous girlfriend . She said the DNA swab would seem to be conclusive. But she said I should get a blood test which I will do.

Then she hit me with something else. Upon looking at my pubic area she saw a small dot of skin darker in tone than surrounding skin.  She said it looked like HPV to her!!!!  So she biopsied it and will send to a lab.  Needless to say, my head is spinning.  The DNA swab said I was negative for HPV but positive for HSV II.  Now I'm full circle and may have both!

[Still_Worried_]

I believe that fluid is an inefficient way to transmit HSV. (I'm sure Terri will correct me if I'm incorrect).  If you were infected due to this exposure, she could have been shedding anywhere from her genital area & the friction and heat from the sex massaged the virus into your skin.

I, too, think it's odd that you contracted it from this single, protected exposure, although it does happen.  Is it possible to contact this partner to see if she tests positive for HSV II?  I know closure is important.

[Jazzman1950]

What is daily home swabbing and how can I do it?

[Jazzman1950]

I forgot to ask you to answer whether H 2 is so easily transmitted by vaginal fluid touching the pubis. It just sounds unbelieveable that I got it this way.  However, the lesion ONLY appeared a few days after protected sex with this woman.

[Jazzman1950]

I know that this is difficult to answer but I thought that with Herpes 2 the original lesion goes away and may or may not return.  How could I be active for over three months?  I had the swab test 3 months after the lesion had healed.  However, it still itched and there was the small flesh coplored bump that he swabbed. The skin is healed but still itches as do my testicles and anus.  Have you ever heard of a case of Herpes 2 where the lesion healed but remained active for so long a period of time?  I agree that it must have been active enough at the time of the swab test for it to come back positive. But that was three months after I got the original lesion!   In light of this clearer chronology is it more likely that the itching is fungal?  Or could the area still be active from H-2?  I live on the gulf coast of Florida. Do I see a dermatologist, ID dr. or urologist?   I have been to 2 dermatologists, one ID doctor and I just saw a second uro this past Friday and he said he saw no sign of active H-2.  Any suggestions for where to go?  I will go anywhere in the US.  Is there a medical mecca for treatment of these conditions? I am just at my wits end.

[Terri Warren, RN, Adult Nurse Practitioner]

I'm not clear that we have that exact number.

Terri

[Still_Worried_]

Thanks for responding!!   I've actually seen Dr. HHH & Dr. Hook state the risk as low as 1 in 1000, or even 1 in 10,000, exposures but I can't get my head around it being THAT low of a risk??  

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, 10-40% of the time is what the studies show, which is actually quite a wide range of numbers, but it has to do with how frequently daily home swabbing is done - the more swabbing, the more virus is found.

I'm not clear that 1 in 100 is accurate, but that sounds about right.
Terri

[Still_Worried_]

When you stated that the virus is much more active than we previously thought, has any studies been performed lately that have assigned an updated estimate?  I've read on this forum that it is present from 10-40% of the time.  Is this correct?  Is the risk to transmit it still in the neighborhood 1 in 100 exposures? (Unprotected, avoiding breakouts).

Thank you!!!

[Terri Warren, RN, Adult Nurse Practitioner]

I wonder if perhaps the dermatologist missed the herpes diagnosis the first time.  A red itchy patch is not consistent with HPV but is consistent with HSV 2.  The red testicles and itchy anus are certainly consistent with a fungal infection (jock itch).  The DNA swab test for HSV 2 is conclusive - you don't need a blood antibody test.  But to say it is dormant is an error.  First, if there was enough virus to make the swab test positive, it certainly is not dormant.  And the other thing is that once you have herpes, one cannot know for certain at any time if the virus is dormant because the virus is much more often active than we previously thought, even when there are no symptoms present.  

The herpes could have been acquired from the woman 3 months ago or any previous sex partner that you have had in your life, there is no way to know for sure.  

Antiviral therapy can be taken for resolution of outbreaks or to reduce viral shedding and thus reduce the possibility of infecting someone else.  We know that most new cases of herpes are transmitted from someone showing no symptoms at the time of infection, so the doctor who is saying that you are active only when you have sores is way off base.  The itching could be due to herpes or due to fungal infection, but you are still potentially infectious, even if you have no symptoms.  

I'm not sure who you should see.  It sounds like the clinicians in your area are not well educated about herpes.  Where do you live?

Terri