Previous Type 1 infection was mild with no recurrences, now what to expect from type 2?

Hello,

My girlfriend has antibodies for both type 1 and type 2 herpes, and when we started dating, I did not have any.  I got what looked like two mild herpes blisters on my lip and one on my penis, so I went to a dermatologist.  She told me I had herpes, prescribed Valtrex once a day for 10 days, and gave me a blood test.  The test (igg) came back negative, and she said that I did not have herpes.  I suspected she was wrong and I didn't have time for antibodies to form, but I left and didn't think about it again.  I never had another outbreak, and my primary outbreak was pain-free and gone in a few weeks.

A few weeks ago, I developed sores on my penis.  At first, I thought they were a result of sex without proper lubrication, and rough oral sex.  I also had what felt like a mild UTI (frequent need to urinate, and feeling like I still had to go when I was finished).  I went to a urologist, who tested me for a UTI and asked about my penis.  I told him it was from rough sex and he didn't say anything else about it except not to be too rough when I wash it and to abstain from sex while it healed.  After a few weeks, they hadn't healed, so I went back, and he said it looked like genital HSV.  I got a blood test and tested positive for HSV 1 but negative for HSV 2 (the test was done three weeks after initial symptom onset).  He said he didn't know if the sores were a result of HSV 1 and he did not have a skin test at his office.  I found another doctor who had a skin test, and was tested.  I Also picked up some valtrex, just in case it was herpes.  The results were that I was positive for HSV 2.  I don't know how good the test was, as I am in a foreign country and the report is not in English, but it does say "HSV DNA (PCR)" on the report.  I will go get another blood test in a few months to confirm it.

I have two questions, but only one is really important.

The really important question is: Can I expect to have a low recurrence rate of HSV 2 since I never had a recurrence of HSV 1?  To ask in a broader way, is there any correlation in how one person's body will handle HSV 1 and HSV 2?  I don't mind having HSV 2 too much, since my girlfriend of many years has antibodies so I don't have to worry about infecting her, but I am a bit nervous about the inconvenience and pain of recurrences.

The less important question is: is there any chance that the positive result for HSV 2 is wrong and this is just a stronger HSV 1 outbreak than I had initially?  Is that likely?

Thanks a lot to anyone and everyone who answers.  I looked all over the internet for information about the HSV 1-HSV 2 correlation but couldn't find anything.  I REALLY appreciate it!

[gracefromHHP]

even the best blood tests still miss 1 out of every 10 hsv1 infections. hard to tell if you truly recently acquired hsv1 or if you had it previously and it didn't show up on previous testing.   At this point, best you can do is wait and should you get a return of oral symptoms, be seen promptly for a repeat lesion culture. These need to be done within 48 hours of the appearance of symptoms.  

Only time will tell how often you have recurrences of hsv2. Since your current partner also has hsv2, it's not an issue.  were the two of you taking any precautions to reduce transmission?  ( just being curious )

grace

[worriedoverhere]

Thanks for the reply, Grace.  I think I might have worded my previous post awkwardly.  I am sure that I acquired HSV1 about two years ago (the recent one was HSV2).  I got HSV1 both orally and genitally, but have never had a recurrence.  In addition, my only outbreak was my primary one and it was very mild (two sores on my mouth, one on my penis).

My big question is whether there is any correlation between how your body reacts to HSV 1 and how it reacts to HSV 2.  If there is, it would be a good sign, since I have never had a recurrence of HSV 1 orally or genitally in two years and my body has reacted as well as possible to it.

I am just hoping that I don't get many recurrences and that if/when I do, they are very mild.  I am hoping that with all of your experience, you might have an idea about whether or not I can expect a mild schedule of recurrences based on my body's reaction to HSV 1, or if there is no correlation (I know that there is not a 100% answer, but I would like to know if this is usually the case).

To answer your question, no we did not take any steps to reduce transmission.  She never had any idea of what herpes can actually do, and her gyno was a terrible doctor (she told her that since she has antibodies to HSV 1 and 2, she cannot pass the infection on to another person, and also told her that she may have caught it originally from a pool or toilet seat).  At my insistence, she has changed gynos .  On my end, I carelessly thought that between her lack of outbreaks and my prior exposure to oral/genital hsv 1, we would be safe...I feel pretty stupid now though.

Also, I would like to note that my lesion culture was done several weeks after symptom onset (but there were still active lesions); I am guessing that that does not invalidate a positive test result, but if I am wrong, please let me know.  Thanks so much for your time, and thoughtful reply; it means a lot to me!

[gracefromHHP]

typically hsv1 genitally doesn't reoccur very often. Not the same for hsv2.  

a pcr swab looks for actual herpes dna. Small chance it misidentified hsv1 as being hsv2 but odds are it is hsv2.  repeating your blood test in a few months to confirm if you need the peace of mind is fine if you feel the need to.

if you both haven't read the free herpes handbook yet by terri warren, our medhelp herpes expert, it's a terrific source of basic info. Her book "the good news about the bad news" is even better and under $20 on amazon. It goes into far more details than the handbook for you both.


keep asking questions!

[worriedoverhere]

Thanks Grace!  To clarify my previous question about HSV 1 being an indicator for HSV 2, I was referring to the fact that I didn't have a severe outbreak and had no recurrences orally or genitally, not just genitally.  Is there any correlation there, or they two different animals.  I know the two viruses are very similar, so I could see the body reacting in a similarly mild or harsh way to HSV 1 orally as it does to HSV 2 genitally.  I could also see there being no correlation at all.  I am just checking here to see if that correlation exists, or if a past experience with oral/genital HSV1 has nothing to do with how you will react to genital HSV 2.  Thanks a lot!

[gracefromHHP]

no there is absolutely no correlation as I've already pointed out.  

[worriedoverhere]

OK thanks a lot; I was hoping that there was, but I guess that was wishful thinking.

One more question: my sores have healed but now my skin is all pink (all the pigmentation is gone).  How long does it usually take for the skin to return to normal color?  Thanks!

[gracefromHHP]

that varies from person to person. it can be days or even weeks for some folks.