What do I have VHS-1 or VHS-2 ?

Two days before my primary genital OB a man performed oral sex on me. He also penetrated the tip of his pennis into my vagina briefly and stopped. He had no signs of any sores oral or genital. I was completly drunk. Two days later I started genital OB and my IGM test and cultur test was positive. My doctor said I need to wait six weeks before I can find out if it is VHS-1 or VHS-2. Do you think in this senario I contracted VHS-1 or VHS-2?

[petal130]

Call back and request that they "type" your culture. They should have done that regardless - no need to wait 6 weeks (which also is somewhat incorrect as it can take longer to show in your bloodwork if this is a new infection).

Could you have got this from the encounter you describe? Yes. Two days later is prime time, and oral sex (perhaps more so than the brief genital encounter) could have transmitted the virus. That being said, if you've never been tested before, it could be an existing infection. Only a blood test taken at the same time as the culture can determine that.

At this point too, ask your partner if he's been tested; if not he'll need an IgG type specific blood test.

Also, it's HSV1 and HSV2. You can read more about genital herpes here in the Herpes Handbook. http://www.westoverheights.com/genital_herpes/handbook/view_the_chapters.html

[jen4321]

I have genitel herpes. Still dont know which type. Doctor told me they cant find out from culture and I have to wait for blood test in 6 weeks. What are the statistics of transfering genitel to genitel using a condom for type 1 and what are the statistics of transfering type 2 genitel to genitel  while using a condom?

[gracefromHHP]

your provider is wrong. they can and should be typing all herpes cultures they send out.

odds are this is hsv1 genitally from him performing oral sex on you. Getting the lesion culture typed would confirm that much quicker and much more accurately than the blood test will.

the herpes handbook at www.westoverheights.com is a terrific resource that is free, accurate and up to date.

grace

[jen4321]

My doctor was very anoyed and hostile towards me for asking about the culture typing. He said that it is our procedure to wait for blood test to determine typing because it is more accurate than culture. He was so mad at me for calling his office several times to inquire about typing my culture  to the point where he mad me cry. Since my culture was detroyed  after all this time, he is going to do the Igg typing at 4 weeks. Is there a chance I could find the type that soon?
Thank you for your help

[gracefromHHP]

typically the lab keeps them for awhile.

I'd report him to the clinic manager. they need to be updating their herpes knowledge and doing better testing. The CDC herpes guidelines are very clear about typing cultures and doing it all properly.

grace

[gracefromHHP]

waiting 4 weeks for testing isn't long enough either. you need to wait 3 months to do the igg blood testing.

[jen4321]

My doctor is my OBGYN and there is no body higher than him to report to. I am desperately wanting to find out what type I have.
I just read on http://www.biokitusa.com/NCCLS_BK_HSV-2_Whole_Bood.pdf
that HSV-2 specific antibodies reach peak levels at 4 to 6 weeks.
1.  Shouldnt I do the test at 4 or 6 weeks then? If it comes negative then I can rule out HSV-2 ?
2. Also my doc  said that for supression to take one 400 mg Acyclovair a day. I read on web sites that you should take two 400mg a day. Which one is it? one or two a day for supression?
3.  Also should I not have sex until I find out what type do I have?

[jen4321]

BTW This web site has been the most helpful in getting information. Thank you so much. I wish my doctor was as knowlegable as you are.

[gracefromHHP]

actually you have to wait 4 months until the biokit is most accurate. some folks will test accurately at 4-6 weeks but the majority doesn't until closer to 4 months.

acyclovir is not effective as a once daily dose.  

I'd wait until you find out which type you have before you start suppressive therapy. Most folks with hsv1 genitally don't get enough  benefit from suppressive therapy to make it worth the cost and effort since typically it doesn't reoccur very often and doesn't shed very often either.  

your provider obviously is VERY under educated about herpes and treating it. I suggest finding a new obgyn for the future.  you deserve better care than this!  You shouldn't have to be doing all this hard work on your own and educating your provider on something 1 out of every 4 of his patients has!

grace

[jen4321]

Ok. I am going to do the IGG type testing at 4 weeks and 6 weeks. If it comes negative, I understand that is false negative and I have to do it again. But if it came positive for a spesific type, should I assume that it is accurate?

[gracefromHHP]

do yourself a favor and wait and get tested at 3 months. if you get a return of genital symptoms before then, be seen within 48 hours of their appearance for a lesion culture and insist on typing to be done.

why work yourself up so many times only to know that you still need to repeat your blood testing again later?  just not worth it.

grace

[jen4321]

1. 3 days after my initial primary blisters disappered, I noticed  a couple of small blisters appeared again at night and they were gone by the second morning. What was that?
Could it be another OB 3 days after I had just finished one? and it only lasted one night? ? Is this going to keep on happening?

2.The area between my labia is it redish and glossy. It does not look normal.  Does it stay that way or it will compeletly go back to normal? this might be a stupid question but I have not had this before and dont know what to expect.

3. If there is no cold soars on the mouth could the virus have been transmitted through saliva?

[gracefromHHP]

1  herpes lesions won't last just 1 night this early into things

2  give it some time, if it stays that way for another week, return to your provider for more testing to see what else is going on

3 hsv1 can be present in the saliva but it sheds through the skin and it's the heat and friction of oral sex that transmits it.

grace

[jen4321]

Is there anyway  I can read all  Dr. hunter Handsfield questions and answers about herpes only without having to go through all the other STD questions?
Has he written any books about herpes? Does he do phone consultation? or in person consultation?
Thanks

[gracefromHHP]

no he doesn't do phone consults. he hasn't written any books.

Terri Warren our herpes expert recently wrote "the good news about the bad news". Available through amazon for under $15.

grace

[jen4321]

Thanks.
1. Is there anyway  I can read all  Dr. hunter Handsfield questions and answers about herpes only without having to go through all the other STD questions?

2. Do the blisters go away completely and the skin go back as before OB or you will always have a trace to where the blisters were?
    It has been one month and I still can tell where the blisters were?

[gracefromHHP]

click on forum archives on the std experts forum and then click on the herpes section.

typically you can't tell at all where symptoms were after it heals if it's on the genital mucosa ( not the thighs or buttocks ).

[jen4321]

I just got my Igg test back. Keep in mind that I was infected 4 weeks ago and I was negative for both types 4 weeks ago.
Igg HSV-1  2.85   positive
Igg HSV-2  0.91  equivocal

since HSV-2 is equivocal, is there a chance that I got infected with both types at the same time? or should I  assume that the HSV-2 is negative since I am already testing positive for HSV-1?
I will do the test again in 6 weeks but in the mean time I wanted to know your thoughts for my peace of mind.
Thank you.

[jen4321]

Actually I just read my test results Igg HSV-2 is less than 0.91 so it is a Negative.
The doc misread it.

I wonder how many people out there get the wrong results from thier doc?

When I did my first Igg test 4 weeks ago, 3 nurses from my doc office  gave me three different results.

I STRONGLY recommend that people should get a copy of their test results and know for sure what they have.
Thank you for all your help

[gracefromHHP]

at this point you still can't rely on your test results at all. should you get a return of symptoms before the next 2 months is up, be seen promptly for a lesion culture and typing.  your provider erred greatly and is costing you a lot of time and money by not typing your culture when it was done :(

grace

[jen4321]

It has been a night mare the last 4 weeks dealing with my provider. They have made one mistake after the other and I had to pay the price for it emotionaly and monetary.
I am going to a different OBGY now and I am much happier with her.
I will definitly follow what you said and retest  again.

[jen4321]

In order not to transmit HSV-1 genital what do you recomend beside not having sex during outbreaks?
1. Do you recomend condoms?
2. Since daily suppresive therapy is not recommended for HSV-1, can it just be used  to reduce transmission of genital HSV-1 during sexual activity? can I take Acyclovair before I have sex ? and how many days before I have I have sex should I start taking it? and what is the dose?
Thanks

[gracefromHHP]

no, taking antivirals prior to sex isn't effective in protecting a partner. takes 5 days of suppressive therapy before it reduces shedding of hsv2. we don't have info as to if they even are effective significantly for reducing hsv1 shedding.

what is your partners hsv1 status?

grace

[jen4321]

Do not know other person status.
Are condoms suffient ? or should I take suppresive therapy 5 days before as an extra measure? What is the recommended dose for acyclovair for suppression?
Thank you

[gracefromHHP]

we don't really recommend suppressive therapy for hsv1 genitally. it doesn't reoccur very often and hardly sheds.  odds are you won't transmit it to a partner.

what is your partner's hsv1 status?

[jen4321]

I dont have a partner. But when I have sex I want to make sure that I won't transmit.
Should I always use condoms then? or even without condoms the odds are that I won't transmit to a partner?
Thank so much for responding so quickly.

[gracefromHHP]

I recommend condoms for the beginning of a relationship. hpv is very common, we don't test for it and it's protecting yourself if you are using them for  a new partner.  talk to future partners about their std testing in general.  ask them to get tested and to make sure hsv is included in their testing. once you know their status, you can make educated decisions about what precautions to take together.

grace

[jen4321]

FYI I had my first primary genital hsv1 two months ago.

This last Friday I started having discomfort and tingling and noticed 2 pimples one on each side of my vagania on the outside and redness inside the labia where the first OB occured two months ago. I took Acyclovair. The tingling  and discomfort continued Saturday and I kept on taking Acyclovair. Sunday the tingling went away and the two pimples and redness almost gone.
Since I am new at this I can't tell, was that an OB that lasted 2 days but didn't materlized to blisters? or was it something else?
Thanks.

[gracefromHHP]

it's unfortunate that you treated this instead of going to be seen for a lesion culture and typing. you would've gotten much faster results as to your status potentially instead of having to still wait for the blood test.

recurrences will be milder and heal faster. at this point no way to know what was going on since you weren't seen.

grace

[jen4321]

But it never materlized to a lesion that could be cultured.
So can a recurrence be just tingling discomfort without lesions? or do people get lesions with every recurrence?

[gracefromHHP]

you won't always get obvious lesions, especially if you start the acyclovir in a timely manner.

grace

[jen4321]

It has been 8 months since my primary genital OB. I have not had any other OB since then. I have confirmed that it is HSV1 with a blood test. I do not have HSV2.
My OBGYN doc recommends taking acyclovir 4 times a day for 7 days before having sex. She is indifferent to type 1 and type 2 and treats them the same way. It is very depressing because I doubt very much that she makes the same recommendation to half of her patients who probably have HSV1.  I don't know if she is ignorant or just covering her ***?
I have lost every desire to have sex. I am not in a relationship but would like to have casual sex a few times a year. What precautions should I take? And how can I overcome this mental ordeal?

[gracefromHHP]

your provider isn't very knowledgeable about herpes from the sounds of things :(

you can transmit hsv1 genitally to a partner but overall the risks are low. avoiding sex when you have obvious genital symptoms and using condoms really keep the odds in favor of not transmitting it.

So what do you do for one night stand type situations?  well talk to your partner about std's and testing. find out if they are getting testing done and talk to them about your own testing and genital hsv1.  you are still at risk of contracting hsv2 so you want to know their status to help protect yourself.  It would be naive to think that someone you barely know is being 100% truthful with you but it's a risk you take so I always just made sure I was utilizing barrier protection ( and crossed my fingers sometimes...he he he ).  Also remember that condoms work best if they go on when the clothes come off. Just waiting for actual penetration to use them allows for a lot of skin on skin contact.

keep asking questions!