Herpes Expert Forum
Oral Herpes
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Oral Herpes

About 3 weeks ago I performed oral sex on a guy and 6 days later I developed flu like symptoms, fever of 102 and a severe sore throat with many ulcers. A viral culture was positive for HSV-2 and blood IgG were both negative for HSV1 and 2. I was placed on a 7 day course of valtrex at 1000mg twice a day and the symptoms cleared up.

I've been symptom free for the past 2 weeks and I thought everything done, but now I'm starting to develop really bad night sweats, fevers in the 100 - 101 range at night and a few ulcers have reappeared in the back of my throat again.  This reminds me of my first outbreak, but only milder.  I went back to the doctor and he put me on Valtrex again and I've been on it for 3 days now.  However, today I'm seeing a blister starting to appear between my nose and upper lip despite being on Valtrex at 1000mg twice a day.

I've been doing a lot of reading on you forum trying to make sense of everything (thank you for all you do, by the way).  Could I ask you a few questions?  

1. Is what I'm experiencing typical for a primary outbreak?  I mean for it to go away, be symptom free for a few weeks and then have the symptoms return again with a blister outside my mouth?  I've never had blisters around my mouth in the past (no HSV-1 exposure).

2. I've read that oral HSV-2 doesn't re-activate as often and people are usually symptom free. Yet, I seem to be having a tough time getting a handle on this...does this mean my body is having trouble fighting the virus and I can expect to have constant problems in the future?

3. Do you have any further recommendations for my symptoms?  I'm currently on Valtrex 1000mg twice a day.

4. I only performed oral sex on the guy.  Is there any risk I have HSV-2 on my genitals or around my butt?  Could I have also gotten HIV from this exposure since I obviously contracted HSV-2?

Thank you so much for your time...
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1. Is what I'm experiencing typical for a primary outbreak?  I mean for it to go away, be symptom free for a few weeks and then have the symptoms return again with a blister outside my mouth?  I've never had blisters around my mouth in the past (no HSV-1 exposure).

Yes, this is very typical for a first infection.  If you were my patient, I would put you on suppressive therapy for the next six months, and I would probably use 1000 mg twice a day, as you already are, since you seem to be breaking through quite a bit.  Your HSV 1 antibody test suggests that you have never had an oral or genital infection with HSV 1.  

2. I've read that oral HSV-2 doesn't re-activate as often and people are usually symptom free. Yet, I seem to be having a tough time getting a handle on this...does this mean my body is having trouble fighting the virus and I can expect to have constant problems in the future?

I just means that this infection is so new that your body has not yet figured out how two deal with the virus.  It's working on it, but hasn't had time to figure it all out yet.  It will, and your recurrences and viral shedding will be infrequent since it is HSV 2 orally.

3. Do you have any further recommendations for my symptoms?  I'm currently on Valtrex 1000mg twice a day.  

I would stay on these doses for a month or so, and then back off to 500 mg twice a day and see how you do.

4. I only performed oral sex on the guy.  Is there any risk I have HSV-2 on my genitals or around my butt?  Could I have also gotten HIV from this exposure since I obviously contracted HSV-2?

It is unusual to have HSV 2 only orally, but as we see more people just having oral sex and no intercourse, it may be becoming more common.  If you had no genital to genital contact at all, your genitals are not at risk.  I would be careful, during the first infection, just to wash your hands (not excessively) after touching the genital area.  During the first months after new infection, it is slightly possible to move the infection from one body location to another, so just be careful.

I think you'll be fine, but you need time for your immune system to catch up to your infection.

Terri
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Terri Warren, RN, Adult Nurse Pr...Blank
Westover Heights Clinic
Portland, OR
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