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Risk of transmission, Oral HSV-2
Ok, so my situation... 40 year old male, straight.
I have had several clean STD panels (all tests, HIV, Herpes I,II, Gonorrhea, Chlamydia etc.) over the last couple years. I recently had a one night stand with someone that involved french kissing and me performing oral sex on her which lasted maybe 45 minutes. She also briefly performed unprotected oral sex on me and we had brief vaginal sex that may have lasted a minute.
Prior to this encounter I had clean tests as mentioned. Exactly 7 days after this encounter I got what I first thought were pimples on my chin (itching, then bumps, which turned into blisters leaking yellow fluid then scabbed over). This finally healed (2-3 weeks after the initial physical symptoms. This also combined with swollen lymph node in my throat, general flu-like symptoms, sore throat etc. Taking aspirin helped the flu like symptoms. After about 7 days of symptoms and 14 days from the encounter I got another 10 test STD panel which still showed negative across the board. I was still ramping up my knowledge and now understand it takes longer than that for the antibodies to form.
Earlier this week I got another panel that showed positive for hsv-2 IgG of 18.
As an aside, prior to this encounter I had been taking about 5g of l-arginine supplement for heart health (I have high blood pressure and am on blood pressure meds). From what I read now, this was probably the worst thing I could have been taking.
I have not had symptoms anywhere else (nothing in my genital area) and my chin has healed. I stopped taking the arginine supplement a couple days into the outbreak when I learned it can aggravate what I thought I had. I also started taking l-lysine supplements and am changing my diet to l-lysine rich foods.
So with that background... my questions:
Long term:
1. Assuming I don't have any genital outbreaks is there any way to definitively determine the presence or absence of genital herpes?
2. What are the risks I may transfer my oral HSV-2 to my partner (through light kissing, deep/French kissing, oral sex). The transmission rates I have seen seem to be related to genital HSV-2 transmission to a partner and what I can find on oral HSV-2 transmission seems to be fairly low, on the order of asymptomatic shedding 1% of the time or 3-4 days a year.
2.a Sub question on this... if I have another outbreak on my face (say chin again) is it on the area of the outbreak that is shedding and subject to transfer of the virus? Would my lips and saliva also contain the virus? What about the rest of my face?
3. Making the assumption for a moment that I only have oral HSV-2, is there any real-world data around frequency of recurrence? Since the OB was on my chin, is the site of the first OB normally the site where it happens again or could it be anywhere in the facial area?
Short term:
1. As my body builds the anti-bodies and I recover from this initial OB are there any special concerns I should have about transmission now that are different from the long term/life long concerns.
I have had several clean STD panels (all tests, HIV, Herpes I,II, Gonorrhea, Chlamydia etc.) over the last couple years. I recently had a one night stand with someone that involved french kissing and me performing oral sex on her which lasted maybe 45 minutes. She also briefly performed unprotected oral sex on me and we had brief vaginal sex that may have lasted a minute.
Prior to this encounter I had clean tests as mentioned. Exactly 7 days after this encounter I got what I first thought were pimples on my chin (itching, then bumps, which turned into blisters leaking yellow fluid then scabbed over). This finally healed (2-3 weeks after the initial physical symptoms. This also combined with swollen lymph node in my throat, general flu-like symptoms, sore throat etc. Taking aspirin helped the flu like symptoms. After about 7 days of symptoms and 14 days from the encounter I got another 10 test STD panel which still showed negative across the board. I was still ramping up my knowledge and now understand it takes longer than that for the antibodies to form.
Earlier this week I got another panel that showed positive for hsv-2 IgG of 18.
As an aside, prior to this encounter I had been taking about 5g of l-arginine supplement for heart health (I have high blood pressure and am on blood pressure meds). From what I read now, this was probably the worst thing I could have been taking.
I have not had symptoms anywhere else (nothing in my genital area) and my chin has healed. I stopped taking the arginine supplement a couple days into the outbreak when I learned it can aggravate what I thought I had. I also started taking l-lysine supplements and am changing my diet to l-lysine rich foods.
So with that background... my questions:
Long term:
1. Assuming I don't have any genital outbreaks is there any way to definitively determine the presence or absence of genital herpes?
2. What are the risks I may transfer my oral HSV-2 to my partner (through light kissing, deep/French kissing, oral sex). The transmission rates I have seen seem to be related to genital HSV-2 transmission to a partner and what I can find on oral HSV-2 transmission seems to be fairly low, on the order of asymptomatic shedding 1% of the time or 3-4 days a year.
2.a Sub question on this... if I have another outbreak on my face (say chin again) is it on the area of the outbreak that is shedding and subject to transfer of the virus? Would my lips and saliva also contain the virus? What about the rest of my face?
3. Making the assumption for a moment that I only have oral HSV-2, is there any real-world data around frequency of recurrence? Since the OB was on my chin, is the site of the first OB normally the site where it happens again or could it be anywhere in the facial area?
Short term:
1. As my body builds the anti-bodies and I recover from this initial OB are there any special concerns I should have about transmission now that are different from the long term/life long concerns.
Thanks, appreciate your help and more info. I wonder... if 18.2 is high for so recent an infection, could the fact I was taking l-arginine at the time (which I understand helps or feeds the viral replication) have pushed the antibody response so high in such a short period of time?
Look forward to Howard's input.
Look forward to Howard's input.
Here are the values from the negative result on 3/17. Its difficult to copy/paste but is says "negative" for HSV2 on the lab work detail with a value <.91. I was wrong about the scale, it is probably what you were thinking:
HSV 2 IgG, Type Spec <0.91
index 0.00 - 0.90
Negative 1.09
The 2nd test from 3/31 with a value of 18.2 is:
HSV 2 IgG, Type Spec 18.20 High
index 0.00 - 0.90 01
Negative 1.09
As I mentioned in my subsequent response above, I have also received negative results from a test in January of this year and the couple I took last year (which were the first ones I have ever taken so I have no history of test values before say June 2014).
HSV 2 IgG, Type Spec <0.91
index 0.00 - 0.90
Negative 1.09
The 2nd test from 3/31 with a value of 18.2 is:
HSV 2 IgG, Type Spec 18.20 High
index 0.00 - 0.90 01
Negative 1.09
As I mentioned in my subsequent response above, I have also received negative results from a test in January of this year and the couple I took last year (which were the first ones I have ever taken so I have no history of test values before say June 2014).
I would mention a false positive test but that would only be for number showing up below 3.5
If you had an igG type specific test where it states that above 1.2 is positive then youve had this prior to the affair and was missed on the first test as at best miss 10% of infections. Or there was a mess up with the number. Do you happen to have and can post here a copy of both your tests for hsv?
I should also re-iterate I have had the same panel of tests back in January and a couple times in 2014 and they were always completely negative. This last test is the only test I have ever had that indicated anything wrong and the this outbreak from 3/11/2015 is the first time I have had any symptoms (at least on my skin) that are consistent with HSV.
Here are the dates:
3/4/2015 The Encounter
3/11/2014 First onset of symptoms (itching, raised bumps on chin) which felt like a pimple then progressed as described above.
3/17/2014 Full panel STD including HSV1 and HSV2 tests, all negative
3/31/2014 Same full panel STD including HSV1 and HSV2. HSV2 tested positive this time.
3/4/2015 The Encounter
3/11/2014 First onset of symptoms (itching, raised bumps on chin) which felt like a pimple then progressed as described above.
3/17/2014 Full panel STD including HSV1 and HSV2 tests, all negative
3/31/2014 Same full panel STD including HSV1 and HSV2. HSV2 tested positive this time.
I need to back up here and this is the problem with long posts. If you took the blood test 10 days after the encounter you for sure did not contact it from her.Please confirm the time you test the test after the affair?
The problem with oral hsv2 is so uncommon that much is really known about it. What is known is that a person first outbreak is usually this last and shedding is close to zero. So if you are positive for hsv2 oral, that would be the preferred location to have it.
Did you also contact it genitally? I will say that those that do have it in both areas got it at the same time otherwise a person is basicly immune to getting it in another area.
A couple of things i like to mention. If she did not have any genital sores at the time your risk of contacting hsv2 would be close to zero from a one time affair. Also herpes blisters are clear liquid not yellow.
If youve never tested for hsv2 before, im of the opinion yourve had this from before as an 18 igg is very high and infers an old infection. And that your chin issues it bacterial.
Did you also contact it genitally? I will say that those that do have it in both areas got it at the same time otherwise a person is basicly immune to getting it in another area.
A couple of things i like to mention. If she did not have any genital sores at the time your risk of contacting hsv2 would be close to zero from a one time affair. Also herpes blisters are clear liquid not yellow.
If youve never tested for hsv2 before, im of the opinion yourve had this from before as an 18 igg is very high and infers an old infection. And that your chin issues it bacterial.
Thanks for the response and clarity, it helps!
Yes, it was a type specific test, HSV1 was negative and HSV2 was positive (<.91 is negative, <1.1 is inconclusive so my value of 18 was positive.
So here is what I know:
According to the tests I definitely have HSV2, and not HSV1
I more than likely acquired it from the person I mention as I had no other partners recently (or since my prior, clear STD tests)
The outbreak symptoms on my chin were consistent with HSV so the symptoms and the recent positive test can only lead me to believe that I have oral hsv-2. If I do get legions again I will try to get them swabbed though.
The only question for me is whether I also have genital herpes as a result of this encounter. I am hoping that lack of symptoms to date down there is a strong indicator I don't, but I suppose time will tell.
Yes, it was a type specific test, HSV1 was negative and HSV2 was positive (<.91 is negative, <1.1 is inconclusive so my value of 18 was positive.
So here is what I know:
According to the tests I definitely have HSV2, and not HSV1
I more than likely acquired it from the person I mention as I had no other partners recently (or since my prior, clear STD tests)
The outbreak symptoms on my chin were consistent with HSV so the symptoms and the recent positive test can only lead me to believe that I have oral hsv-2. If I do get legions again I will try to get them swabbed though.
The only question for me is whether I also have genital herpes as a result of this encounter. I am hoping that lack of symptoms to date down there is a strong indicator I don't, but I suppose time will tell.
Regard to your first question, swabbing of a sore is the only way to confirm location
Hi,
1. Not sure what your question is but if you took an igG herpes type speicfic test that states any number above 1.2 is positive an you had an 18 for hsv2, the would be conclusive. Shedding also occurs about 15% of the time. Many people never have symptoms
.
2.If your implying that you have ORAL hsv2 its not common at all and unless you have a swab of a face sore that confirm hsv2, we would assume your hsv2 is genital. (assume).
And if you do have hsv2 oral is doesnot breakout that often and shedding is close to Zero at about 1 or 2% of the time. So transmitting it hsv2 by kissing would only be a risk if you have a recent lip or chin sore.
Shedding can occur any where in the neck up area and is amost zero shedding. It is not in the saliva but can be passed through saliva in a protected enviornment.
3. Most outbreaks occur in the same spot give or take an inch.
4. No but its most important to have the next chin sore swabbed within 48 hours after appearing. Imperitive.
1. Not sure what your question is but if you took an igG herpes type speicfic test that states any number above 1.2 is positive an you had an 18 for hsv2, the would be conclusive. Shedding also occurs about 15% of the time. Many people never have symptoms
.
2.If your implying that you have ORAL hsv2 its not common at all and unless you have a swab of a face sore that confirm hsv2, we would assume your hsv2 is genital. (assume).
And if you do have hsv2 oral is doesnot breakout that often and shedding is close to Zero at about 1 or 2% of the time. So transmitting it hsv2 by kissing would only be a risk if you have a recent lip or chin sore.
Shedding can occur any where in the neck up area and is amost zero shedding. It is not in the saliva but can be passed through saliva in a protected enviornment.
3. Most outbreaks occur in the same spot give or take an inch.
4. No but its most important to have the next chin sore swabbed within 48 hours after appearing. Imperitive.
Also, I have been in communication with the woman who I had the encounter with, she is getting tested, though I don't have her results yet.
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
