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How to tell if HSV-2 infection is recent v's old...?
I was exposed to a man with an oral cold sore 2 weeks ago (he has never been typed, but presumed that it was HSV-1). As soon as he was sure it was an outbreak, we ceased contact, but there was some contact after he first had the tingling/burning symptoms.
~1 week later, my nipple became sore, and a day later a small sore appeared. It looks like a small canker sore on my nipple, and was only painful four a couple of days. I have been keeping it clean and bandaged, and it has not really changed much in the last week.
I went to a clinic right away, who recommended getting a blood test, without swabbing the nipple. The doctor said it looked like it could be a herpes sore, although the margin was not as red as she normally sees.
The test came back positive today for HSV-2, with a result of greater than 5 (1.5 is positive, as I understand). I was told it was negative for HSV-1 (I'm cautious here, as initially the doctor said I was positive for HSV-1 and not 2, but then he corrected himself to the results I described above.
I dated a man with type 2 orally about 5 years ago, but have not (knowingly) interacted with anyone with herpes of any kind since, until this man 2 weeks ago.
A friend told me that there is a way to get a sense of if it is a recent or longer term infection from the results, although I'm not sure what that is.
So these are my questions:
1. How can I get a sense of whether this is a recent or long term infection? (There are more people that I would want to contact if it is a longer term infection)
2. It seems like a good idea for me to get this sore swabbed, just to make sure it is HSV, and not something else...any thoughts on this? My understanding is that if this is an outbreak, I will have the sore for at least another week, maybe longer (I'm not taking any medication, and am just bandaging with a general herbal ointment), so I can go in next week and still be 'swabable'!
3. Is there anything I'm missing/overlooking/not thinking about...?
I would try to have this swabbed before it heals that is the only way you will know for sure which type you have although I think it would be more likely to be HSV1 and recently aquired if there was skin to skin contact in that area with someone who was having an outbreak even if it wasn't yet showing.
I am not contradicting what your doctor said by any means I'm just saying what my thoughts on this are on the basis that oral HSV1 is more infectious during an outbreak than oral HSV2 which seldom has any outbreaks at all after the first one and both types seem to cause less problems when they are outwith their prefered site.
We reviewed the test results, clearly stating >5 for HSV-2 and <0.9 for HSV-1.
He believes (as do I) that the HSV-2 diagnosis comes from a previous infection, and that the sore on my nipple is most likely HSV-1 from the recent encounter, and that there was not enough time for the antibodies to show up in the test.
The results next week should either confirm or deny (or confuse!) this theory.
In the meantime, I'm still getting my head around the diagnosis.
Hsv2 provides you with significant protection against contracting hsv1 later on but it's not 100%. Without a lesion culture you really won't get fast answers. If it's been more than a couple of days since this lesion started, it's too late for a lesion culture. did they prescribe any antivirals?
Testing hsv2+ a week into this means it's not a new infection for you.
It can take up to 4 months or so for the hsv1 antibodies to show up on the blood test. No reason to retest anytime soon.
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