HSV-2 offering protection against HSV-1?

[notworried]

I'm a 28 year old female with genital HSV-2 determined by HerpeSelect (I am negative for HSV-1). I contracted HSV-2 either 19 months ago through a partner that tested false-negative, or in fall of 2004 during two protected encounters with one individual whose HSV status is unknown to me. However, I only began experiencing neuralgia approximately 12 months ago. My symptoms: shooting pain everywhere in my body down to fingertips and toes and in my nodes (even underarm nodes), neck and headaches; itching, terrible burning, extreme sensitivity and pain in the vaginal area (hurts to wear underwear or to have a clean sheet skim over the crotch); flu aches and feverishness. To my knowledge I've never had an open blister or sore, which is what made the process of getting a diagnosis exceedingly protracted and difficult. Most gyns thought I was just crazy.

I also contracted hrHPV (probably more than one strain) 19 months ago. Feel like a walking STD here despite all the precautions I have taken.

I am now seeing someone who has oral HSV-1 and is awaiting his results for HSV-2. Here are my questions:

1) Does preexisting HSV-2 definitively protect you against HSV-1? Does it matter where the HSV-1 is located; i.e. oral or genital? I am afraid to kiss this guy because of the severity of my HSV-2 symptoms. I cannot imagine what having oral HSV-1 on top of my genital HSV-2 would be like given that my HSV-2 symptoms are so severe, constant and uncontrollable (see below). If the answer is yes, PLEASE direct me to studies so that I may further educate myself.

2) What is the next step if any for drug-resistant HSV-2? My neuralgia is terrible and occurs 24/7 and is NOT responsive to Valtrex (which I can't take anyway, as it causes explosive digestive problems).

Thanks for any help.

[auntiejessi]

Hi there -

There is a lot of evidence that says you are not likely at all to get hsv1 after hsv2.  I still wouldn't come into contact with an outbreak of hsv1 - I wouldn't kiss someone with a cold sore, for example, but other than that, you don't have much to worry about.

You won't like my answer for the neuralgia.  While I firmly believe that PHN exists (and many don't), you wouldn't be getting it all over your body.  Herpes infects nerve groups, and genital herpes infects the sacral ganglia.  The sacral ganglia starts at the waist, and goes down, so you wouldn't be getting nerve issues all over your body.

That said, you clearly have something going on.  You might need to see a neurologist to get some answers.  Even if it were being caused by hsv2, you need to treat neuralgia as you would any other nerve issue, and valtrex doesn't help with nerves.  Regardless of the cause of the neuralgia, you have to treat it as its own issue.  There are several treatments that might help, but you should see a neurologist for this.

If you decide to treat herpes with suppressive therapy, you might try acyclovir.  Its less medication at one time, and you have to take it twice a day, so you might not have the stomach issues with it.

Good luck!

AJ

[notworried]

Thank you AJ, I forgot to mention that I have had extensive workups for this--CT, MRI, MRA (contrast dye), physical exams...and my neuralgia is primarily from the waist down, BUT lately has also moved into my arms down fingertips, and armpits. Also, so far I haven't seen an OB "break" the skin barrier, but with the way things are progressing/worsening I would hardly be surprised, but I do develop extreme redness in the area that hurts the most in the upper public area. Same place every time. I thought herpes was supposed to get BETTER over time, not worse?

I recognize that this is a VERY unusual presentation for g. herpes, but it is mine, and in the absence of other neuro problems, I can only attribute it to herpes. It actually makes sense to me given that herpes is a virus that lives in the nerves. I also know that PHN is more typically seen in older people with herpes zoster and doesn't much occur with g. herpes EXCEPT in prodromes.

I wonder if what I am experiencing is a series of continually aborted OBs? The redness and escalation then peak of neuralgia then it dies down to a more bearable "hum" then starts again...but it never goes away.

Would you mind directing me to the studies that show HSV-2 protects against HSV-1? If we're not allowed to link can you give me terms or names to look up?

Appreciate your input...and thanks again!

[auntiejessi]

You've had all those tests done, and no one has put you on any meds like lyrica, etc?  

And your theory about obs makes sense.  In actuality, your red spot might actually BE an ob.  Not everyone gets blisters.  I've had herpes for 3 years, and sometimes I just get a really red, irritated spot.

If that's the case, though, you might try using acyclovir, or even famvir, suppressively, along with something like lyrica.  

I don't know of an actual study offhand, and I don't have the time to look one up (you are free to look it up on pubmed).  Here is an article, though, and it quotes Anna Wald about hsv1 after hsv2.  I would trust anything she says - she is one of the most respected herpes researchers in the world.

http://www.herpes.com/hsv1-2.html

AJ