second hsv1 ob, after 5 years

[ouchers1]

I was diagnosed with genital hsv 1 over 5 years ago.  I believe I had a culture and blood test done, from what I remember.  I barely even remember my first outbreak, but I did go ahead and take acyclovir for about 2 years after the initial outbreak.  After I didn't have an outbreak for so long, I quit taking it.  

Now, 5 years later, out of nowhere, I started itching and burning really bad.  I honestly thought I had a yeast infection and took a Diflucan for it.  After about 5 days or itching and burning, the lesions started appearing and I could not believe I was having an outbreak.  I actually had some Acyclovir from a few years back (hope it's not bad by now) so I started taking its getting much better.  I do NOT remember my first outbreak being this miserable.  SOOOOO uncomfortable.  It's lasted for about 10 days now and I'm thinking this seems VERY LONG for an outbreak.   Now I'm so worried I'm going to start having outbreaks again.  I've read that many people with genital hsv 1 never have another outbreak after the first one.  This will be my first one, to my knowledge, in 5 years.  Does the fact that I had one mean they may start occurring more frequently, or will it most likely be another 5 years before I have another one?   And should a recurring outbreak be lasting this long?  Thanks.

[ouchers1]

It's been less than 2 months since I posted this and I was having my first (I think) outbreak (hsv1 genital) in 5 years.  Well, I believe I am having one again now.  I just let that last one run it's course and took anti-virals, but I can sense another one is coming on now.  

I made an appt to see my doctor as soon as I can, which is 2 days away.  Can someone suggest what I need to ask the doctor and what tests I need to take?  And why on earth after 5 years of nothing would I get 2 within 2 months??  Thanks.

[ehbeedub]

From what I've read, antivirals are only really effective if you take them as soon as the outbreak starts. Otherwise, it will just run its typical course. This does seem like a long outbreak for a recurrence, but it's probably just an abnormality. No real reason to think that you'll suddenly start getting them like this all the time.

Your husband should have a type-specific test done, as well. 90% of people who have herpes don't know it, either because they're completely asymptomatic (less likely) or because they simply attribute their symptoms to other things.

Let us know the results when you have them!

[ouchers1]

I am even curious if the anti-virals are actually helping or if it's just getting better b/c it's ran it's course?

[ouchers1]

Yeah I did take the diflucan and it actually got worse after that. The first 4 or 5 days was mostly just itching, burning, discomfort (hence why I thought a yeast infection), then the papercuts/lesions/blisters appeared.  Since I started taking the anti-virals its gotten better daily.  At this point they almost look like they are kind of scabbing over, I guess that's how to explain it.  They definitely feel much much better.  NO, my husband hasn't ever had a type-specific test.  He's just never had anything to suggest he would have either type, not even type 1 orally.  

[ehbeedub]

While the rule is that recurrences tend to be less severe, they can still be bad at times. If the antivirals aren't helping, you should probably see a doctor for a fresh prescription (I'm not sure about their expiration date, but 3+ years old is probably not great!). I can't really say that it's definitely an outbreak, but it sounds like one. You might want to check for yeast, which can cause some pretty nasty symptoms, as well, though if Diflucan didn't help, that's less likely.

Has your husband ever had a type-specific herpes test?

[ouchers1]

Thank you.  From what I explained from my symptoms, this does sound like an hsv outbreak, right?  I cannot imagine what else it could be.  And seeing as I am married and in a monogamous relationship (for 3.5 years now), it can't be new exposure to hsv.  This is all baffling to me.  I had accepted a long time ago that I had hsv 1 and thought I was fortunate to not have any recurring outbreaks.  

[ehbeedub]

I'd recommend another blood test, especially since the first one was done so close to your initial outbreak. You might also try to obtain the actual results from your tests to make sure that the swab wasn't typed, to see the dates of how things happened, etc.

The testing can be complicated but here are the basics relevant to your situation: antibody tests take anywhere from 2 weeks (at the absolute earliest) to 6 months (at the absolute latest) to become positive. Nearly everyone can be tested at 4 months for a conclusive result. If you were tested a couple of weeks after your initial outbreak, especially if you were on Valtrex, that is not a reliable result. You should be retested now, years later, off Valtrex, etc.

[ouchers1]

Yes, I guess it was just assumed b/c of the blood test.  I went it, had the swab and the results came back positive.  So then a blood test was done and it was negative for type 2 but positive for type 1.  So, should I have another blood test done?  The testing for all of this is kind of confusing to me, especially since this all happened so long ago.

[ehbeedub]

Just to be clear -- was your swab actually typed five years ago, or was it simply positive for herpes and you assumed HSV-1 because of the blood test? Because the blood test was already positive at the time of your initial outbreak, that suggests a previously-established oral infection, as antibodies take about two weeks minimum to develop.

It's possible that this is just a recurruence of GHSV-1, but it wouldn't hurt to have a blood test to be sure. You said that your husband has neither -- I assume he has been blood tested and is not making that claim simply based on a lack of symptoms?

[ouchers1]

I know 5 years ago we did a swab, it came back positive, so then we did a blood test and it showed that it was HSV1.  That is all I remember of that.  

I also thought it seems a little extreme for a recurring outbreak.  My husband does not have HSV1 or 2.  

I am just confused about this outbreak b/c it does seem so intense.  Like I said, it is getting better, but it's taking quit a while.  By the time these lesions actually go away, it will have been about 2 weeks I'm guessing.  

[Fleetwood20]

This sounds somewhat more like a primary outbreak than a recurrence. Were you completely comfortable with the diagnosis the first time around? Unless the swab was positive you may not have had a true genital diagnosis at that time. A positive HSV-1 blood result would stand a reasonable chance of being an established oral infection, particularly if the blood was drawn inside two weeks of the first lesion appearing.

If you do not have a positive swab result from 5 years ago, then consider obtaining one on these current lesions.

Does your husband know his HSV status?

[ouchers1]

I'm married now and we obviously have sex.  There is no discharge at all.  I can't imagine anything it could be but an outbreak.  At first they kind of looked like papercuts, very small, but they got a little bigger.  I do not recall having this many at all 5 years ago on my initial outbreak.  It's getting less painful, the first few days, wiping after using the bathroom was torture.  

[Life360_Dave]

Hi and welcome. The second outbreak normally is not as painful and can last 10 days. If you have been sexually active and does your discharge have a green tint. It really does not sound like an outbreak as they are more like blisters with no puss.