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Avatar universal

please help with results

Hello,
I am really nervous posting, but I have been reading on here for about a week now. Now that I have my recent STD results in hand, I figure now is the best time to post my concerns.
Just a little background: Im 30/female with only 2 sexual partners. My current boyfriend now (2nd boyfriend) is really the only one I consider to have a full sexual experience with. In the beginning of our relationship-we did the responsible thing and got tested for all STD's. Unfortunately, i was not aware that they don't have hsv testing as part of basic std screening. We were both fine. So I decided to be on the pill and occasionally condoms when I was not good at taking my pills. About two weeks ago, I felt an uncomfortable feeling down there and felt that it was a rash. Almost like my skin had been scraped. The pain became more pronounced and decided to see my gyno. She visually diagnosed me with herpes and I told her that I have always had cold sores since at a very young age and get about 2 to 3 per year, depending on my stress levels. My boyfriend has had no visible symptoms for oral or genital herpes- but he has never been tested with the blood test. My boyfriend and I have not had oral sex for about a year now. To my knowledge, I have never had anything like this happen down there. So this is where my confusion lies. When my doctor told me she would figure out through blood test and culture what type I have and to which I told her I would defintiely test positive for type 1 since I've had this since childhood.

Sure enough, I tested positive for type 1, negative for type 2,, and negative for the culture. And yes, I do plan on re-taking the culture if a "lesion" or whatever it is if it appears again. The thing is, I have read that since I've had hsv 1 since childhood, wouldn't that make me highly resistant to getting it genitally since I have the antibodies for it? What are the chances that I do have HSV1 genital? Another concern I have is if my IgG test for type 2 is negative and I have been wiith the same man for 2 years, then I can definitely be certain that I do not have type 2? Or can my blood test for type 2 be false negative?
I also do get mouth uclers occasionally, but moreso in the past year and a half. Recently (about 2 months) my vision has been blurred at times -and it feels dry, like you have to put wetting drops in it, and I wake up in the morning with crusty eyes, itchy, red, but disippates througout the day. My boyfriend will be tested in his next doctor's visit. Should I consider myself for sure as having genital hsv1 since my doctor says "it's textbook herpes"? How do you I know when it is absolutely safe to be intimate again. As far as I know my lesion never scabbed over. I do sometimes feel like bugs are crawling all over me down there, down my legs, my lower back and my butt cheeks. Can I be just imagining this? Or is this associated with herpes?  Sorry for the long post, my doctor can't seem to answer these for me over the phone as I need another consult and that's not availabe for me until another month. I'm so just tired of feeling the way I do. So much uncertainty. Just as you think you are being super careful, and these things still get at you. Please help me. Thanks in advance.

HSV culture type and typing
Negaitve: No herpes simplex virus isolated

HSV 1 IgG 3.16 index
HSV 2 < 0.91 index.
Please let me know if you need more info on my results.
22 Responses
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101028 tn?1419603004
I knew I had genital herpes, had had that for many years prior to all my other issues starting down yonder and knew what was going on wasn't herpes related. I had to keep going back monthly for over a year to get to the bottom of it all. still don't have great answers but we have answers and a plan in place so that I feel as "normal" down yonder as possible. I just love being female sometimes....not!

Just keep following up on it and hopefully you get better answers in the near future :)

grace
Helpful - 0
Avatar universal
thanks for the advice grace. we have a resort getaway in a couple of weeks. He thinks that we need to get a new hobby together to keep my mind of this. lol. Anyway, so you say "been there done that". so you went through this too? (negatvie results- with symptoms). a little afraid to keep digging at this point, The thought of having it biopsied is scary. just like every time i get cultured is insanely scary.every time, i think "omg-this is it, and its not gonna be good news" but yes, if i get this again, it would be hard to just disregard it.i'll try my best to close this chapter. im emotionally drained.
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101028 tn?1419603004
You can get culture results back in 24-48 hours. no reason to doubt your culture.

I know from my own personal experience how freaking frustrating it is to know that something is going on down yonder but not know what it is. Been there, done that. It totally suck s :(   At this point, I'd certainly stop thinking herpes. You've been tested and are negative and odds are you really don't have it.  If your obgyn isn't able to figure out what is going on, follow up with a dermatologist to try to get better results.  You might even want to give your doc a call and ask what your next step is. Let them know that you are willing to even let them biopsy the lesions the next time they appear if need be too to try to get better answers.  

Meanwhile - use lube for sex ( not the heated ones, flavored ones - just plain ole astroglide or ky ).  Plan really romantic evenings with your man too for the next couple of weeks to help make sure you are really in the mood and feeling relaxed and lovely dovey for sex :)  If he complains, tell him how important it is to you right now to feel really loved and cared for and the need for a little extra tlc :)    

grace
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Avatar universal
also, i forgot to ask. I got the spot cultured on tuesday, the results are back today (fri). 3 days to get the results for culture? Isnt this a little soon? i thought it would take at least a week.
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Avatar universal
Hi Grace!

Doctor just called me. Negative culture again. "No HSV", she said she also tested for bacterial infection-that also came back negative. My boyfriend seem to think that I won't be happy unless im sick. Such an unfair statement, when everytime i sit, i feel discomfort, or wiping myself when i pee. It's hard not to think about it when there is something going on down there.
I read Terri Warren's handbook- Just wanted to get your opinion on this: "One study found that herpes cultures give FALSE NEGATIVE results 76% of the time when compared to the more accurate PCR test described below.  That means that 76% of the time when a culture comes back negative, the person really does have herpes after all, when compared to the same sample run by PCR."
Obviously-the PCR I had asked for was not available to me. I also read that herpes lesions can be flat. Mine never get bubbly or scab over, it just looks like raw white patch of skin. I asked for meds for my cold sore. My boyfriend still seem to think its necessary. I knew that whatever I am experiencing now could not have been a product of our sexual experience last friday night, but i thought it was a recurrence of my first one from July. Same exact location- same exact look- same exact feel. Your thoughts?
Helpful - 0
101028 tn?1419603004
At this point it's wait and see though as I said, it doesn't sound like it's herpes showing up this quickly after sex. Even your provider who actually saw your lesions, didn't think that they were herpetic.

grace
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Avatar universal
Hi Grace,

Got to see my primary doctor today with no problem. She looked at it and didn't think they were herpetic in nature. She still cultured it, but she said something about not getting any fluid out because it didn't have fluid. When she swabbed it, it felt just like it did at my July visit.painful raw skin feel. She seems to think   fluid needed for her to get a good sample. But i came as soon as i felt the irritation (which was definitely within 24-48 hours) of symptoms. Is this true?, that fluid is needed to get a good sample? I also asked for a PCR to be done on it, but she said they couldn't, so a regular culture was done. Waiting for my results in about a week.....What are your thoughts on this whole fluid thing?

Thanks!
Helpful - 0
101028 tn?1419603004
Herpes ob's aren't going to show up that soon after sex. I'm thinking it' s just all irritation from not being relaxed enough during sex along with not having had it in so long.  

grace
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Avatar universal
Hi Grace,

No, I was definitely not relaxed, and yes we used lube. What could it be? Any suggestion on how I can communicate to my providers that I want to see my primary doctor only for this, without having to go into too much details? I don't have a way with words, especially at a the state I am in at the moment. Going into work soon and I can't seem to think of anything else but this. When I see her, any suggestion on what more she can do as to not miss anything?
Helpful - 0
101028 tn?1419603004
I'm sure you weren't as relaxed as you used to be for sex were you? did you use extra lube?

grace
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Avatar universal
Hi Grace...so, i finally had protected intercourse with my boyfriend after almost 4 months of abstaining. He has been on acyclovir 10 days when we had sex on Friday. Obviously, I did not wait the 4 months to be re-tested to definitely rule out type 2. As I sit here, I felt chafing a few hours ago more around my anus area. And had a bit of discharge. I am anticipating my period in a couple of days, but noticed that there is a bump on the area where this whole dilemma started to begin with (and where I was previously cultured in July with a negative result). It looks like a small bump, that feels like raw skin. I am hoping to get tested tomorrow by my doctor, Just wanted to get a jump ahead on what you think this might be from my symptoms. I also feel tingling all over, sometimes the itching reaches my butt cheeks and thighs. It feels like worms are crawling all over me.
Also, I want to be seen by my primary physician as she knows the ordeal i've been through trying to reach the end of this. But being on HMO, she is really busy. I'm not certain she will be available to see me, Any suggestion on how I can communicate this to my providers office without having to go into too much information to people who are not my doctor?

thanks again grace.how i wish this would all end. I feel like sex has so many consequences for me. I'm not certain its worth it for me to go through all this.
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Avatar universal
Thank you so much. I know it takes time to type all that. I will keep the questions coming as I have them. What I should have done is  come here to ask if it is a good idea to see the infectious disease doctor. lol.   It would've saved us the huge fight we had last night. I just want to say, I got through my work day by reading your reply this morning. I sure appreciate it.
Helpful - 0
101028 tn?1419603004
I would not bother retesting on yourself at this point.  You could be a late seroconvertor but the reality is - if you are staying in this relationship, you need to get back into a "normal" relationship together at some point. Now that you know his status and your status is highly likely to be hsv2-, it's time to resume sexual relations and start dealing with his hsv2 as a couple :)   His being on daily suppressive therapy and using condoms means that you are 97-98% likely each year NOT to contract hsv2 from him. very low odds overall and certainly not high enough to stop sexual relations any longer ( not sure how you went this long anyways!!!! ).  I'm sure at this point you both need to get back to some lovin' don't you think?  

http://www.annals.org/cgi/content/full/124/1_Part_1/8  it's an older study and it's only in women but I think it's easy to read the abstract and see that yes indeed, daily suppressive therapy with acyclovir is effective in reducing shedding of the virus. The less virus you shed, the less you are exposing your partner to hsv2 and risking infection in general.  The reason I picked this study was because it specifically addresses shedding of the virus in between obvious lesions.  There's also another good study that showed that in folks who tested + for hsv2 but thought that they had never had symptoms, with proper education, about 80% of folks were able to start recognizing signs of the virus being active/ob's.  With your partner going on suppressive therapy, ob's should be few and far between but it wouldn't be surprising if he didn't start recognizing ob's in the future.  

At this point, I wouldn't bother with more than yearly hsv testing for yourself to see what your status is. Should you get a recurrence of genital symptoms, go and be seen and get a lesion culture and typing done.  Your cold sores are not really an issue for your partner but certainly treat them to help them heal faster so that YOU feel better sooner :)  Herpes antivirals work best if taken in the cold sore doses as soon as you even suspect you might be getting one so keep some handy. No need to wait until you have a full blown obvious cold sore present.    Studies have shown that hsv2 protects significantly against hsv1 but not vice versa so your hsv1 infection isn't a huge issue in this relationship outside of the discomfort of having one.  

Keep asking questions as you have them :)

grace

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Avatar universal
Thanks Grace! Last night through the whole ordeal, I came over his place so we can read Terri Warren's handbook, but he was so frustrated that he wasn't willing to read it last night. After I posted, he told me that he will keep taking the pills, but he would like me to take something for my cold sore.
So true about the infectious disease doctor...from what he says, he has it too and was very so so about it. He said , "i don't even know if the pills are doing anything for you"...."you have nothing going on"!?!?.
I want to get re-tested in a week to mark 4 months, but I don't think my boyfriend can hold out any longer. Do you think it's necessary?
Helpful - 0
101028 tn?1419603004
No wonder you are so frustrated!!!

At this point, I certainly would not assume that you have genital herpes as I've said previously. You only had a visual diagnosis done which is wrong 1/3 of the time even in experienced practitioners.  Your blood tests have all been hsv1+ which you already knew that you had prior to this because of your long history of cold sores. You have significant protection against contracting hsv1 genitally because of your oral infection with hsv1. You certainly did not give yourself hsv1 genitally!

Your bf is hsv2+. I encourage you to have him read the herpes handbook which is free to read online or purchase Terri Warren's "the good news about the bad news" book off of amazon for under $15.  Both are terrific - the book goes into far more details than the handbook .  You should be taking precautions to reduce your odds of infection with his hsv2. I highly recommend daily suppressive therapy for him to reduce your risk since odds are you are of child baring age.  There's no such thing as just being exposed to herpes. This is precisely why I NEVER recommend seeing an infectious disease specialist for help with herpes - I've yet to hear of folks walking away with good answers from it. They tend not to be up to date on genital herpes and how to deal with it as a couple it seems :(  Granted I know some really good ones but most folks are not getting appointments with them unfortunately. they tend to think herpes isn't worth their time it appears.  You were given very erroneous info by the one you saw and it's unfortunate that your bf is thinking doctor = perfect and is wanting to follow his recommendations even though all the literature says otherwise to what you were told.

Should you get a recurrence of your genital rash, be seen within 48 hours for work up but odds are you really don't have genital herpes.

grace
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Avatar universal
Hi Grace

So I'm back, well, I haven't really been away, but just thought I'd wait to give you an update. Unfortunately, my update is rather exhausting as this is how I am feeling at the moment. Emotionally drained-all because of the same issues that brought me here over a month ago.
So here it goes:
I re-tested at 3 months(Aug 10th) after abstaining from sex and my results were the same. + for type 1, neg type 2. My boyfriend soon followed on the 19th and tested neg for type 1 , but + for type 2 (>5.00) IGG Herpeselect. He jumped at the opportunity of getting acyclovir and has been taking them for almost two weeks straight now. Still, we have not had intercourse. As this only puts more weight on my shoulders and I am still not at peace with all this.
Just today, I accompanied him to a visit to an infectious disease doctor who I thought could put this all to rest and answer some important questions for us, but the total opposite happened. He stated to my boyfriend that HE DOES NOT HAVE IT, but has been exposed to  it. and that there is no need to take the medication unless he experiences outbreaks- which he never has in his entire life. He also said that taking it daily is unnecessary,that it was a ploy for pharmaceutical companies to rob money from people.I mentioned to the doctor about what prompted all this testing between the both of us, and he basically said I have type 1. I stated how he thought this, and he  motioned to his finger to his mouth and then his crotch.- (signaling that i gave it to myself that way). He proceeded to tell me to get a couple of good cries until it doesn't bother me anymore!
This of course worried me, as now I am back to square 1- NOT KNOWING and still wondering. Now, I am considering re-testing in a week to complete 4 months with no sex just to absolutely rule out type 2. Now, my boyfriend is siding with his doctor- that he wants to stop taking the meds, because his doctor said so. We just got into a huge fight as i told him this is not so. So, its now become the battle of whose right. I'm really frustrated. I'm mad that i feel we are retracting rather than moving forward. The original plan before we saw this doctor was for him to keep taking the pills, condoms, without lesions/or outbreaks

So I'm not sure where I am with my boyfriend right now about this. I know it will be about what I can handle, but it is hard to decide that when I still feel so burdened and uncertain about all of this and that nothing is really 100% certain.

So timeline summarized is this:
July 2 OB visit: negative culture, negative type 2, positive type 1 (since childhood) (Done by labcorp)
Aug 10 (3 months of abstinence)  negative type 2, positive type 1 (done by labcorp)
August 19th (Boyfriend's status) negative type 1, positive type 2 (done by quest)
No oral sex for over a year now.

Today, we still have not had intercourse, and it is interfering with our relationship.

Questions:

1. Should I really get re-tested to absolutely rule out type 2?
2. Is this infectious disease doctor right in saying that he doesn't have to take it unless he has an OB? How about when its mild and he doesnt notice. (My bf doesn't get this idea) He said he would know.
3. Is it true that I could have genital herpes type 1? If all tests are pointing to NO (neg culture, negative type 1 boyfriend), and oral herpes since childhood?
4. What else can we do to prevent me getting type 2 and him type 1? Should I be on meds too?
5. How likey was that my culture was a false negative?

I just had a thought: That if he and I had broken up today, and I re-test in a week which would be four months after exposure? Can I be certain then, that I have no gential herpes type 1 or 2?

Grace, I hope you give me your advice and put my brain to rest. I'm emotionally exhausted.


Thank you again.
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Avatar universal
thanks grace!
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101028 tn?1419603004
the herpeselect igg blood test can be gotten at 3 months, all others should be gotten at 4 months post possible infection. if your partner gets tested now and is negative then you have your answer.

grace
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Avatar universal
hi grace,

im trying to find articles, before having to ask you, but I seem to be getting different info on when it is safe to test after exposure? I read 4 months, I read you get symptoms between 2 to 20 days of exposure. Can you clarify this for me?
about your reply- i should mention that for the last 3 months before i went to the doctor to get the lesion checked we have been using protection since i have not been on the pill. on a side note: the last month (3rd month) we have been apart- no sex, no contact, so reallly 2 months condom, 1 month no sex sums up the last 3 months before i found out I had what my doctor calls "textbook herpes"

Does this give me a better chance that my test is really negative for type 2?
Grace, thank you for being so patient on this board. You are helping so many people and your help is truly appreciated. I am grateful for what you do.
Helpful - 0
101028 tn?1419603004
If he has hsv2 and recently transmitted it to you, it might take a few weeks/months to show up on the blood tests you just had at the time of your symptoms.

grace
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Avatar universal
thanks grace! so let's just say he is hsv2, then does that mean after two years together it is still possible for it not to show up on my blood test?
also, is it possible that i can be resistant to type 2 since i alerady have type 1?

thank you again.
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101028 tn?1419603004
you have hsv1 orally already. it's very unlikely you'll contract it genitally from your partner.

at this point he needs a type specific herpes igg blood test to see what his status is. tell him to call his doctor this week and ask for the test to be ordered so you can get quicker answers. If he's negative for hsv2 and so are you, then you know that this isn't genital herpes going on.

even the best practioners still misdiagnose genital herpes 1/3 of the time.  no reason to assume that you have to have genital herpes based on a visual exam. Your partner getting tested will give you better answers quicker.

grace
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