Herpes possibility

[hypomb]

Hi Doctor:
I posted in the HIV forum but am guessing i got no response because i was in the wrong forum. I had a brief encounter of unprotected sex, there was no ejaculation and I am a female. The male was fresh out of a long relationship and did not have any herpes medication that i found. He was 33.

My question is what are the chances from contract HSV 2 from this and is it likely that i would have symptoms? I have had none and it has been bout 2 months. I also had a brief insertion 6 months ago with a diff guy before a condom was placed on this literally was probably 2 second.

Given these two episodes, what are your thoughts?

Also, I know i have hsv 1 but assume it is oral since i have never had any symptoms.

Lastly, I do have some minor feminin itching from time to time but nothing that lasts more than a day or a few hours and my discharge is normal from what i can tell.

oh and in your experience, are that many people really asymptomatic or just dont recognize symptoms. what percentage?

Thank you in advance for your reply.

[Edward W Hook, MD]

We do not comment on material seen at other web sites.  This report is a research support, not a clinical trial and as the announcement says was a small study. It was also a laboratory, not a human study and has no relevance to your situation.  EWH

[hypomb]

Can either of you speak to the following i found on webmd?

Gail Shust, MD, and colleagues at Albert Einstein School of Medicine studied the genital fluid from 16 healthy women aged 18 to 25 who were at low risk of acquiring sexually transmitted diseases. Genital fluid has been shown to have natural antimicrobial activity against HSV-2, Shust says.

Nine of the 16 women were using hormonal contraception: Seven were on the pill, one used injectable Depo-Provera, and one the vaginal ring NuvaRing.

Results showed genital fluid from the women using hormonal contraception had significantly less anti-herpes activity compared with the other women, she tells WebMD.

Shust stresses that the study was small and the findings need confirmation in other research.

[Edward W Hook, MD]

Your are asking several questions which I will try to answer but the topic of herpes is a complex one.  By way of background, the disease is common with HSV-1 being present in over 60% of adults and HSV-2 (the virus which causes most genital herpes) being present in about 1 in 5 Americans.  For both infections, the majority of people who have the infections are not aware that they are infected, either because they either acquired it without knowing in the past or because they misidentified their herpes as something else (this is the most common of the two situations).  I will do my best to answer your questions but in general, many of these questions and information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).  Now, for your questions:

1.Your risk of herpes is pretty low for several reasons.  By your history it appears that there are just two partners that you are concerned about. On average 1 in 5 adults has HSV-2 so that is about the odds that one of your partners had HSV-2.  Even if they did however, most exposures to infected partners do not lead to transmission of infection so the odds are in your favor that you did not get herpes from either of the exposures you noted.  If you had, it would be expected that you would have developed symptoms about 3-10 days after your exposure.  Your post suggests that you looked thorough his belongings for herpes medications - I hope that wasn't the case.  It would be easier just to ask.

Also, one other word of advice.  It doesn’t take long to transmit herpes or any other STD – unprotected is unprotected –condoms are really preferable, particularly for casual exposures.  

2.  The fact that you get cold sores (oral) also means that you have partial resistance to infection based on your body's immune response to the HSV-1 infection you have.

3.  The itching you describe does not sound like HSV.

4.  As noted above, most people with herpes know they have lesions but have the diagnosis missed because they call it something else, not because they are truly asymptomatic.

Hope this helps.  EWH