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HSV 2 symptoms - timing of infection
I'm still waiting on WB HSV results but have no doubt that I will be pos for HSV2. I realize that the "when" and "who" of HSV2 infection are sometimes impossible to determine, however, I was hoping you could give me your educated opinion on when I was infected.
June 3-5, 2011 - unprotected sex 3 times with 1 person over 2 days. (1st time I had had sex in 2 yrs.) 3rd time, I had pelvic discomfort during sex with post coital bleeding (cervicitis I'm assuming). Saw my MD 10 d later - pap nl; neg GC and chlamydia. Did not test for BV, yeast, or trich but treated me w 5 d flagyl. I self treated for a yeast infection after that.
Mid July 2011 - pimple/blister on my right labia, groin lymph node soreness. Neg culture by MD ~5 days after appearing. Did not do HSV Igg Abs at this time. No similar sx - not even yeast - until July 2012 as noted below.
March 2012 - 1st sex since 6/2011; unprotected w new partner, 1 time only. ~1 wk later - inc vaginal discharge (very watery, non-irritating, no odor). Resolved after ~7-10 d. No other sx.
July 12 2012 - redness/irritation that developed into a blister on my left labia. Groin lymph node soreness. I was sick w the flu ~2 wks prior but not sick at the time of the blister appearance. Healed within 5-7 d. HSV2 Igg Abs was 4.22 on July 30.
Aug 12 2012 - almost down to the hour, a month later, same exact location is red, irritated with a tiny blister. No other sx.
Do you think that the cervicitis and lesion I experienced in 2011 were indicative of a long standing HSV2 infection? Or is it more likely that 2011 sx were NOT HVS2 related (no recurrence on my rt labia). And that I contracted this from my Mar 2012 encounter given the vaginal discharge 1 wk post sex (appropriate timing for 1st time infection) and the fact that I've had blisters show up in the same spot 2 mo in a row (seemingly more virulent that what I experienced in 2011)?
June 3-5, 2011 - unprotected sex 3 times with 1 person over 2 days. (1st time I had had sex in 2 yrs.) 3rd time, I had pelvic discomfort during sex with post coital bleeding (cervicitis I'm assuming). Saw my MD 10 d later - pap nl; neg GC and chlamydia. Did not test for BV, yeast, or trich but treated me w 5 d flagyl. I self treated for a yeast infection after that.
Mid July 2011 - pimple/blister on my right labia, groin lymph node soreness. Neg culture by MD ~5 days after appearing. Did not do HSV Igg Abs at this time. No similar sx - not even yeast - until July 2012 as noted below.
March 2012 - 1st sex since 6/2011; unprotected w new partner, 1 time only. ~1 wk later - inc vaginal discharge (very watery, non-irritating, no odor). Resolved after ~7-10 d. No other sx.
July 12 2012 - redness/irritation that developed into a blister on my left labia. Groin lymph node soreness. I was sick w the flu ~2 wks prior but not sick at the time of the blister appearance. Healed within 5-7 d. HSV2 Igg Abs was 4.22 on July 30.
Aug 12 2012 - almost down to the hour, a month later, same exact location is red, irritated with a tiny blister. No other sx.
Do you think that the cervicitis and lesion I experienced in 2011 were indicative of a long standing HSV2 infection? Or is it more likely that 2011 sx were NOT HVS2 related (no recurrence on my rt labia). And that I contracted this from my Mar 2012 encounter given the vaginal discharge 1 wk post sex (appropriate timing for 1st time infection) and the fact that I've had blisters show up in the same spot 2 mo in a row (seemingly more virulent that what I experienced in 2011)?
MEDICAL PROFESSIONAL
I understand your continuing concerns -- but agree with your analysis of the main priorities.
FYI, probably the most common situation in which only one or two exposures results in HSV-2 transmission is when the source partner was recently infected, i.e. within the preceding 6 months and especially within a month. That's when viral loads are maximum and the usual low average transmission rates probably don't apply.
I wish you well in adjusting to your herpes. Rest assured that most people do indeed adjust well and live fully satisfying sexual and romantic lives.
FYI, probably the most common situation in which only one or two exposures results in HSV-2 transmission is when the source partner was recently infected, i.e. within the preceding 6 months and especially within a month. That's when viral loads are maximum and the usual low average transmission rates probably don't apply.
I wish you well in adjusting to your herpes. Rest assured that most people do indeed adjust well and live fully satisfying sexual and romantic lives.
Thank you for your thoughtful response. Truth be told, I was actually hoping that I had been infected well before June 2011 - my thought was that if this were the case, my recurrences would be few and far between judging from my symptom history (once per yr). This second lesion in 2 months blew a hole in that and was what made me wonder if this represented a newer infection.
The only other time I can correlate possible HSV2 symptoms to a new partner would have been in 2009. I had sex 3 times (2 protected, 1 not) over the course of the first week in Jan 2009 with one man. Then began a relationship with a different partner (unprotected sex) Apr-July of 2009. I remember having one or 2 self diagnosed yeast infections in early '09 (no discharge, just irritation, itching). But definitely no lesions until July 2011. For that matter, no symptoms that I could even construe into herpes sx for the better part of '09 to 6/2011. It does seem like an odd pattern of recurrences - but I'm assuming not out of the realm of possibility for HSV-2?
Unfortunately, I think I am one of the unlucky individuals who contracted HSV2 after just a few (maybe even 1 or 2) encounters with an infected individual.
Thanks again for helping me make sense of this. I do realize that moving forward and preventing transmission are the most important things. I agree that there's little to be gained in contacting previous partners. Honestly, I think I'm just grasping at some way to predict frequency of recurrences - and of course, there's certainly no precise answer for that either.
The only other time I can correlate possible HSV2 symptoms to a new partner would have been in 2009. I had sex 3 times (2 protected, 1 not) over the course of the first week in Jan 2009 with one man. Then began a relationship with a different partner (unprotected sex) Apr-July of 2009. I remember having one or 2 self diagnosed yeast infections in early '09 (no discharge, just irritation, itching). But definitely no lesions until July 2011. For that matter, no symptoms that I could even construe into herpes sx for the better part of '09 to 6/2011. It does seem like an odd pattern of recurrences - but I'm assuming not out of the realm of possibility for HSV-2?
Unfortunately, I think I am one of the unlucky individuals who contracted HSV2 after just a few (maybe even 1 or 2) encounters with an infected individual.
Thanks again for helping me make sense of this. I do realize that moving forward and preventing transmission are the most important things. I agree that there's little to be gained in contacting previous partners. Honestly, I think I'm just grasping at some way to predict frequency of recurrences - and of course, there's certainly no precise answer for that either.
MEDICAL PROFESSIONAL
Welcome to the forum and thanks for your question.
I glanced at your thread on the herpes community forum. You are correct to be expecting a positive Western blot result for HSV-2. It is rare that a type-specific HSV-2 IgG antibody test (such as HerpeSelect or Captia) with a value of 3.5 or higher is false. In fact, had you been examined and tested in my clinic, we would not have recommended spending the money (and emotional energy) on a WB test. The main purpose of WB is to evaluate patients with weakly positive or negative IgG tests -- not to confirm strongly positive results. In fact, if your WB returns negative, I'm not sure I would believe it!
It is likely your two most recurrent left labial lesions, time in more or less the same location, were due to recurrent HSV-2 outbreaks. If so, then you were infected before July 2012. I would guess you were infected a year earlier -- i.e. it's a reasonable possibility your right labial lesion, accompanied by apparent lymph node inflammation in the groin, was your initial HSV-2 infection. Initial HSV-2 infections in people with prior HSV-1 often are limited, mimicking a recurrent herpes outbreak rather than presenting with the typically greater severity of true primary infection with either HSV type.
That said, the incubation period isn't really consistent. Initial HSV symptoms usually begin within several days, and almost always within 3 weeks of exposure. Your most recent exposure being 5-6 weeks earlier pokes a big hole in that explanation. Therefore, your more recent sexual exposures also are potential sources of HSV-2. Or maybe you were infected before any of these events, i.e. well before June 2011.
That's about as far as we can go in guessing when and where you were infected. The only other way to get a clear answer might be to contact your past partners and ask them whether they have been diagnosed with genital herpes, and perhaps to consider being tested for HSV-2. But my general advice to people in your situation is to not go there.
Sorry I can't answer this as precisely as you hoped, but perhaps these comments have been helpful.
Best wishes--- HHH, MD
I glanced at your thread on the herpes community forum. You are correct to be expecting a positive Western blot result for HSV-2. It is rare that a type-specific HSV-2 IgG antibody test (such as HerpeSelect or Captia) with a value of 3.5 or higher is false. In fact, had you been examined and tested in my clinic, we would not have recommended spending the money (and emotional energy) on a WB test. The main purpose of WB is to evaluate patients with weakly positive or negative IgG tests -- not to confirm strongly positive results. In fact, if your WB returns negative, I'm not sure I would believe it!
It is likely your two most recurrent left labial lesions, time in more or less the same location, were due to recurrent HSV-2 outbreaks. If so, then you were infected before July 2012. I would guess you were infected a year earlier -- i.e. it's a reasonable possibility your right labial lesion, accompanied by apparent lymph node inflammation in the groin, was your initial HSV-2 infection. Initial HSV-2 infections in people with prior HSV-1 often are limited, mimicking a recurrent herpes outbreak rather than presenting with the typically greater severity of true primary infection with either HSV type.
That said, the incubation period isn't really consistent. Initial HSV symptoms usually begin within several days, and almost always within 3 weeks of exposure. Your most recent exposure being 5-6 weeks earlier pokes a big hole in that explanation. Therefore, your more recent sexual exposures also are potential sources of HSV-2. Or maybe you were infected before any of these events, i.e. well before June 2011.
That's about as far as we can go in guessing when and where you were infected. The only other way to get a clear answer might be to contact your past partners and ask them whether they have been diagnosed with genital herpes, and perhaps to consider being tested for HSV-2. But my general advice to people in your situation is to not go there.
Sorry I can't answer this as precisely as you hoped, but perhaps these comments have been helpful.
Best wishes--- HHH, MD
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
