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Confused With HSV

I am a 21 yr old male no sex for roughly a month, then on may 17th I had protected sex with GirlA; one night stand. There was no penile to vaginal contact without a condom whatsoever, she did give me unprotected oral sex. Once finished I took off the condom and I washed my penis with water and soap. Then, on May 22nd I had unprotected sex with GirlB, I have had unprotected sex with her before with no ramifications.

On may 26th I noticed a painful burning sensation when I would urinate. The following day I noticed a white bump that I simply thought was an ingrown hair, so I tried to pick it with index finger. That day I went to the sexual health clinic urinated in a cup to test for chlamydia/gonorrhea. Family doctor appt or June 1.

From the 28th to June 1st, my penis and right index finger severely worsened. I noticed that what I thought was an ingrown hair had turned into an open sore, along with other open sores that formed a cluster; at the base of my penis/bottom of my shaft. Roughly 5 red open sores, along with 2 or 3 separated single ones near the top of my penis (noticeable gap between the cluster at the base and the single-sores). The sores on my penis did not hurt or itch whatsoever, I think putting purel on them out of paranoia made them not itch? My finger was intensely painful. When I looked close I could see pin-head red dots underneath my skin and my nail looked bruised

Doctors response, "that is 100% herpes and herpes whitlow." He then swabbed a sore, my finger, and a blood test. He prescribed me valtrex for life and gave me Apo-Cephalex for my finger because it was bacteria infection aswell. Now June 27th and I have an appt July 4th to discuss the results. I have talked to GirlA and GirlB both swear they are COMPLETELY std free  

Dr. thinks GirlA gave me herpes-location not covered by condom. I find it very confusing that both of these girls are positive they are clean. Since taking valtrex my sores scabbed, left slight scarring no ob since


5 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Sorry, you are oversimplifying things and perhaps taking them out of context.  Both of us on this forum have had patients in whom genital HSV-1 was transmitted to a sex partner.  it happens but, as I said, is quite rare.  Do I think you need to worry- no.  Can I absolutely guarantee you that you will not transmit genital HSV-1 to a partner, no.  

So, what would I do.  Condoms for sure unless you know your partner has HSV-1, in the form of cold sores or other evidence. Once a person has HSV-1, they cannot get it again.  As I said, valacyclovir suppression has not been studied for genital HSV-1 and will not be (too rare and would require far too large a study).  Suppressive therapy would, in theory, be of some benefit.  Finally, disclosure of he fact is always a good thing.  EWH
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Avatar universal
to quote you colleague Dr. Handsfied, "even if you acquired your infection genitally, you aren't going to transmit it to a future sex partner or your future children.  Corollary:  People who are HSV-1-positive have no ethical obligation to inform sex partners of possible genital herpes." http://www.medhelp.org/posts/STDs/Genital-HSV-1/show/245290

I also read on this forum that genital to genital HSV 1 transmission or a genital to oral HSV 1 transmission does not happen? Thus, the only path of HSV 1 transmission is oral to oral, or oral to genital.

Therefore:

1)  Can I have a regular sex life with genital HSV 1 (should I not be worried of infecting partners as long as there is no visible signs on my penis)?

2)I am curious as why it cannot be passed from genital to oral or genital to genital (thus, is it even possible to transmit from the genital region)?

3) If you don't recommend Valtrex, how do you suppose I should deal/treat my genital HSV 1?

Thank you sir
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
A few comments.

Valacyclovir suppressive therapy for prevention of recurrences and transmission is something that clearly helps persons with genital HSV-2.  The value for persons with genital HSV-1 is less clear since: a)  genital HSV-1 rarely recurs, recurring only about 1 16th as commonly as HSV-2; 2.  There is little asymptomatic shedding of genital HSV-1 (the primary mode of transmission) and ; 3.  genital HSV-1 is rarely transmitted to sexual partners, about half of whom are not vulnerable to further HSV-1 infection since they already have it, whether they know it or not  (about 50-60% of adults have HSV-1 most of whom do not know they ahve it).

If you take valacyclovir an wear condoms, there is little chance of tranmission of infection.

There are no curative therapies for HSV on the horizon.  

Hope this helps. Take care. EWH
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Avatar universal
My apologies on using the term "clean" as someone who is free of STD's, the 2000 character limit had me pick the smallest words I could find, by no means do I associate people with STDs as dirty, as I myself have one.

Dear Doctor,
I just got home from my appointment with my family doctor is the discussion of results. The swab test came back positive for HSV-1 on my genitals. Therefore, I do not have HSV-2. He and I believe it was from receiving unprotected oral sex from GirlA I descried in my original.  posting. That explains both girls denial of having any, or a history of STD's.

He told me I should continue my lifetime Valtrex 500mg dosage as it will help (in most cases) entirely suppress the virus since it is HSV 1 rather then HSV 2. I live in Canada and am covered, therefore money is not an issue and I am happy taking Valtrex daily for safe-of-mind.

My question to you is; can you describe the difference of genital HSV 1, compared to HSV 2? Your thoughts on lifetime Valtrex 500mg daily? And my risks of Asymptomatic/ symptomatic shedding with Genital HSV 1 and Valtrex? And if no visible sores are shown, I am taking Valtrex and I do wear a condom, chances of passing it onto partners? Lastly, in your professional opinion, your estimation of when if there will ever be a cure for Genital HSV 1 and if so, when?

P.S. Do you know of any studies where I can sign up to be a "lab rat" and have upcoming HVS cures tested on me?

Thanks, I know it is 4th of July in the States so a reply that takes a few days would be understood. Thanks.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  The only way to know for sure if you have genital herpes or not is with a swab or PCR test taken from a lesion.  Blood tests are often not useful for this purpose and unfortunately, doctors are wrong about 20-25% of the time when they call a sore herpes.  On the other hand, the lesions you  describe at the base of your penis certainly do sound like herpes.   Personally, I think you would be better off with a definitive diagnosis.  If your earlier tests were not positive, then I would stop the valacyclovir and wait to see if there is a recurrence.  When there is, a test to make sure it is HSV and to know what type (HSV-1 or HSV-2), taken ASAP after the appearance of the lesion should help (type of virus is important- there is little need to take chronic valacyclovir if your lesions turn out to be HSV but are HSV-1.  Suppressive therapy is of proven benefit only for persons with HSV-2).

As far as your partners are concerned, at least 20-25% of adults have genital HSV and of these, only about 20% are aware that they have the infection.  Since most HSV is spread by persons who are asymptomatic or who attribute their symptoms to something other than HSV (like an ingrown hair), it is quite possible than one or both of them has HSV but is unaware of this. The way for them to have a better idea is to be vigilant for lesions that can be tested and to consider seeking a type-specific test for HSV-antibodies with a test such as the HerpeSelect or other  type-specific test.

Finally a word about your partners and choice of words.  I suspect both of your partners are, to use your term, "clean".  STDs are not a matter of dirt or abnormal behavior and to suggest that persons who might have an STD are unclean only serves to create barriers to sorting out problems such as yours.  It is important for people to know if they have STDs, not because they are clean or unclean but so that they can seek management to make sex safe for themselves and their sexual partners.

Hope these comments are helpful to you.  EWH
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