its been confirmed - hsv2

[lzb1023]

Hi Dr Terri,  I contacted you back in July regarding my first outbreak of herpes on my anus. Unfortunately I dont recall the login name/pswd so I had to add a new one. Anyway, my results back then were hsv1=1.64 and hsv2 =1.61.  you asked I wait 4 months in which I just got retested last week, full panel, including the herpes test.  The results are, hsv1=1.31 and hsv2=4.0.  I had a culture done in july when I first got the outbreak, but they didn't type it, but I'm sure I can safely assume now it was hsv2 by the numbers.

here are my questions;

1.  since i only had the outbreak on my anus, is my vagina also infected and/or contagious?
2.  if my bf of a year and half gave this to me and since he's never had an outbreak and passed it to me by shedding, could he then shed it and pass it to my vagina too?
3.  since i've never had an outbreak before, do these numbers show that he possibly gave this to me?

Our relationship has stuggled a bit since this finding, me blaming him mostly, but we are still together and trying to work this out.  My bf is not concerned and doesnt feel it should change our sex life, but it has big time for me, I cant seem to get past it when we are together. I wanted him to get tested and he was more then willing and we really tried to find a clinic in our area since he doesnt have insurance, but we cant find a place here that will do the herpes test, frustrating, they dont include it in there testing. I really appreciate your time and knowledge.
Thanks again for all your help.  

PS, my gp gave me a video after my last appt and you were the host on the video speaking about herpes, very imformative!  

[Terri Warren, RN, Adult Nurse Practitioner]

I'm sorry the relationship didn't work out, but sometimes a bad event, a stressful even like this one, can tell you a lot about how someone performs under pressure.  And though herpes seems very bad right now, there are worse things and tougher times when you will need a partner who will behave perhaps in a stronger way.  

There is so much to know about telling partners.  I cover this in a 30 page chapter in my book, The Good News about the Bad News, you can get it from Amazon.  Its just too long to write here.  I would also suggest that you download the Updated Herpes Handbook for free at our website, westoverheights.com and also, while there, watch the patient counseling DVD.

Terri

[lzb1023]

Well our relationship has not survived these results so my question to you now is how do I tell potential partners and when is a good time?  Do I need to go over surpressive therapy for the heck of it?  It'll be 5 months with no further outbreaks.

It's ashame how this all turned out and the results are not all to blame, but it just intensified every other little things that were wrong, way too much for me, so it's time to move on.

He still hasn't gotten tested and honestly I don't think he ever will.  To him it didn't seem important and I think it's because he has never seen an outbreak or had to deal with one.  I hope he tells his future partners, but that's not for me to worry about.  I'm worried about how men are going to look at me and not give me a chance because they are worried.

If you can help answer my questions that would be wonderful. Challenging road ahead, wish me luck.

Lisa

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, having HSV 1 first will likely reduce the severity and/or frequency of the HSV 2 presentations.  If the outbreaks are uncomfortable for you and/or your partner is uninfected, you could take daily therapy to reduce these symptomatic appearances.  You can either take acyclovir 400 mg twice daily or valacyclovir (Valtrex) 500 mg once daily.  Valtrex will be generic in December, so it will be cheaper then than it is right now.  

Terri

[lzb1023]

Thanks for your feedback.  My GP told me that I was not contagious in the vagina area being the outbreaks will majority of the time wind up only in that area of the anus.  I was hoping he was right, but it seems he was wrong and I could possibly see an outbreak on my vagina at some point, that makes me sad.  

I will talk to my bf about the testing website and see what can be done from there, but I do have one additional question,  

The hsv1 numbers were low both times and I was confirmed with having hsv1 orally by a dermotologist years ago, 20+ to be exact.

Having hsv1, will this help at all with reoccurrences of the hsv 2 genitally?  I know hsv2 outbreaks occur more frequent, so I was hoping to at least find some positive light on this since I already have hsv1 that possibly it would help in some way making the outbreaks less frequent.  Knock on wood, I haven't had a genital OB since July, but again dont know much about how often they should occur. Haven't had an oral outbreak in 4 years (knock on wood).  

thanks again, LZB    

[Terri Warren, RN, Adult Nurse Practitioner]

1.  Yes, you are infectious from the genital tract as well as the anus.  The whole area is innervated by the same set of nerves, and the virus travels on them to get to the surface of the skin.  
2.  Because of my answer to #1, this is not a concern.  
3.  Your index value numbers on your antibody test results SUGGEST that he gave it to you, but we cannot be certain.

It is important that he get tested, for sure.  If you are both infected, then herpes doesn't need to be an issue at all in your relationship.  You can have sex whenever you are both comfortable.  I would strongly suggest that you use an online testing service.  I like healthcheckusa.com.  They offer only the IgG testing, which is what you want.  Let's have you get that done and then we can talk more if he is negative for HSV 2, which is possible.  If he is, then you got this from a different sex partner, but this is all speculation, facts are better.  

I'm glad you liked the video, it makes me sad that these videos will likely no longer be distributed when Valtrex goes off patent in December, but it is available on my clinic website, westoverheights.com

Stay in touch, OK?

Terri