Hsv2 from Exposures

[Justnervous]

Hello doctor. 17 days ago I had protected sex with a Caucasian women that when I ejaculated in her, I pulled out and the condom was broken. I told her to go get tested which she made the appointment the next day. She went got a pelvic/speculum check, which didn't show nothing abnormal or any sores. 5 days later when had protected sex 2 times, which the condom didn't break. So the next day she gets a call from the doctors saying she tested Hsv2 positive. She went to the doctors that day and didn't see anything abnormal in her vagina again by doing the pelvic/speculum check on her. She said the last time she got tested was in June and didnt have hsv2. She was surprised she tested positive for hsv2 and she hasn't had no symptoms of it. So it's a new infection. Last time she had sex was with her ex in December. She called him when she tested positive and he told her that he has hsv2. She said that she only had unprotected sex with him 2 times only. Well doctor I'm just real nervous and can't stop thinking about this. I've been online reading on hsv2 and studies they did from different clinics and etc. Well for myself I got a baseline test 10 days after the exposure which everything came back negative except for hsv1, which I had for years now. I've been to the dermatologist twice because two days from the broken condom incident, I had a dark spot on the head of the penis which was dark and the dermatologist said it was a bruise. It wasn't no bump just a dark circle spot. Then I went again because I had two rashes underneath the balls and butt cheeks, which was fungus. I just been itchy all around my genitals, even my butt too. Just nervous to have sex with my wife because she's pregnant and don't want to infect her with hsv2, if I'm infected with it. I been making excuses to not have sex with her.

1. What's the chances of me being infected with hsv2 from these exposures? So I just leave this behind and move on?

[Justnervous]

Hey. How are you doctor. Well just a update. I tested negative from an IgG blood test from labcorp at the 7 week and 3 days from the broken condom and 6 weeks and 5 days from the protected condom with a hsv2 positive women. With these results am I confident that I didn't contract hsv2 from these exposures. Thanks doctor. By the way I haven't had no sores and lesions, when I saw something that's not normal I went to the dermatologist which always said its not herpes. Thanks doctor.

[Justnervous]

Thanks again doctor hook. So just move on with my life  from this because I didn't contract hsv2 from these exposures? Thanks again for the thanks for answering my concerns Doctor Hook.

[Edward W Hook, MD]

Sigh, you are really having trouble letting go, aren't you.  If you must test, nearly all HSV-2 infections in persons who already have HSV-1 will be detected by the HerpeSelect at six months.

Condoms reduce the risk for acquistion of genital herpes by about 60% but not entirely.

It is time for this thread to end. you may post your results but there will be no further responses to questions and continuuing questions will be deleted without comment. EWH

[Justnervous]

Thanks doctor hook. That's a really really low chance to be infected with it. I would test at the 6 week mark and I'll post up my results here. Thanks again Doctor. One last thing. It's been 14 days since the protected sex with her and 19 days from the broken condom incident with her. Should I be concern of the protected sex I had with her or be concern about the broken condom incident?

Would I have to wait 12 weeks or 16 weeks to have a conclusive test result since I'm hsv1 positive. That's all doctor hook. Thanks again Sir. Sorry for the "what if" questions, just nervous and anxious of this Doctor Hook.

[Edward W Hook, MD]

I have little patience with "what if" questions. They do neither you nor me much good.  You are now 14 days out from your single unprotected exposure and have not had an outbreak (itching is a sign of genitally focused anxiety, not herpes)- the chances that you aquired HSV are tiny and should not concern you.

Brief answers to your questions:
1. You mention very low to contract hsv2, which hsv2 is a new infection to her. The 1 out of a 1000 exposures someone has or how is that explained? Is that a 4% chance of being infected with it. Also is it true that it's more unlikely for a guy to contract hsv2 from a women, how does that work?

This is garbled.  If you have sex with an infected partner your risk of getting infected is less than 1 in 1,000 and probably closer to 1 in 10,000.  1in 1000 is a 0.1% chance, i.e. 99.9% change that you were not infected.    This is a "back of the envelope" estimate by experts, considering the available scientific data.

2. Just for peace of mind, would you suggest to test at the 6 week or 8 week mark from the broken condom date or last time I had sex with her which was protected date. Because there's a 5 days difference from the broken condom to the protected sexy. If I test negative on either week you suggest me to test on, should I believe that test result and move on without thinking I have hsv2 from these exposures. Know doctor I'm hsv1 positive, so I don't know if that delays antibodies for hsv2 and if it does how long does it delay the antibodies for hsv2 and what week would be better for me to test since I'm hsv1 positive to get a reassurance that I didn't contract hsv2 from these exposures. 6 or 8 week.  

HSV-1 slightly delays development of HSV-2 antibodies but not much.  At six weeks nearly 2/3 of persons with HSV-1 who acquired HSV-2 will have a positive HerpeSelect assay.  With HSV-1, your risk of having a false positve is higher than your risk of having HSV-2 after a single contact.

3. Just nervous because my wife wants to have sex, which she's pregnant but I'm scared to infect her with hsv2, if I contracted it from these exposures. What's your advice on this doctor?

You'll have to decide.  I doubt that you acquired HSV, as I told you.  

4. How accurate are the herpes select IgG test after 6 weeks? In your career have you seen or heard anyone test negative from 6-8 week range from the exposure and weeks later test positive?

See above.  Thus, obviously, there are people who develop positive antibody tests six weeks after exposure.  

Please no further "what if" questions. EWH

[Justnervous]

Thanks for your responds doctor Hook.
Well I did get tested for all stds 10 days after the broken condom exposure and tested positive for hsv1. Also it's been 19 days from the broken exposure and 14 days from the protected sex with the same women that's hsv2 positive and no sores/lesions/blisters around my genitals. Just itchiness.

1. You mention very low to contract hsv2, which hsv2 is a new infection to her. The 1 out of a 1000 exposures someone has or how is that explained? Is that a 4% chance of being infected with it. Also is it true that it's more unlikely for a guy to contract hsv2 from a women, how does that work?
2. Just for peace of mind, would you suggest to test at the 6 week or 8 week mark from the broken condom date or last time I had sex with her which was protected date. Because there's a 5 days difference from the broken condom to the protected sexy. If I test negative on either week you suggest me to test on, should I believe that test result and move on without thinking I have hsv2 from these exposures. Know doctor I'm hsv1 positive, so I don't know if that delays antibodies for hsv2 and if it does how long does it delay the antibodies for hsv2 and what week would be better for me to test since I'm hsv1 positive to get a reassurance that I didn't contract hsv2 from these exposures. 6 or 8 week.  
3. Just nervous because my wife wants to have sex, which she's pregnant but I'm scared to infect her with hsv2, if I contracted it from these exposures. What's your advice on this doctor?
4. How accurate are the herpes select IgG test after 6 weeks? In your career have you seen or heard anyone test negative from 6-8 week range from the exposure and weeks later test positive?

Thanks Again for your Knowledge and Help with this difficult situation that's taking a toll out of me day and night Doctor Hook. Thanks again.

[Edward W Hook, MD]

Welcome to the Forum and thanks for your appreciation of our expertise (FYI, although my Dad was an Infectious Disease specialist, he did not do STD research).  The exposure you describe was low risk for herpes and, in my opinion, since she has not had an outbreak, your partner should be tested further before she decides she has HSV-2 for sure.  If her tentative diagnosis is based on a blood test, it may be falsely positive, particularly depending on her test and its numerical value (I will not comment further on her test results here so please don't ask.)  Even if she has HSV-2, most exposures to infected partners do not lead to infection and, in the absence of lesions we estimate your risk for getting HSV from the condom break/unprotected exposure you describe to be less than 1 in 1000

1. What's the chances of me being infected with hsv2 from these exposures? So I just leave this behind and move on?
see above- very low.  If you do not develop HSV genital lesions in the 14 days following exposure, I would not worry further and would not suggest further blood tests (they are too often falsely positive).

2. If I take a herpes select IgG test at the 6 week mark of the last exposure and test negative, should I believe that test result that I didn't get infected with Hsv2 and move on? How accurate is that test at 6 weeks, though I'm hsv1 positive? San Fransico Clinic states that 6-8 weeks gives your very accurate test results.
The HSV IgG tests are not reliable enough for us o recommend them for routine diagnosis of infection.  Particularly since you already have HSV-1 your risk of a falsely positive test is high.

3. I've read that being hsv1 positive you get a 50% protection from getting infected with hsv2, is that true?
Estimates as to how great the protection is vary however it is clear that persons with HSV-1 are somewhat less susceptible to HSV-2 than persons who do not have HSV-1.


4. From your knowledge, which you're a member from Astda, published stds books and if it's dr. Handsfield winner for best infectious doctor from the CDC convention, do you think its safe for me to have sex with my wife that's pregnant without infecting her with hvs2 or any other std. Just don't want to infect her.
Your risk for other STIs such as chlamydia form an unprotected exposure is higher than your risk for HSV.  You may wish to be screened for chlamydial infection using a urine test (typically gonorrhea testing is performed on the same specimen)

5.  I just been itchy but no sores or blisters at all. Might be itchy because I'm nervous.
Itching is a common manifestation of anxiety.  If your itching was due to HSV, lesions would be expected to follow within a few hours of the onset of your itch.

6. Could it be that I could be infected with hsv2 and not have no symptoms at all because I'm hsv1 positive already?
Most unlikely.

I hope these comments are helpful.  EWH

[Justnervous]

2. If I take a herpes select IgG test at the 6 week mark of the last exposure and test negative, should I believe that test result that I didn't get infected with Hsv2 and move on? How accurate is that test at 6 weeks, though I'm hsv1 positive? San Fransico Clinic states that 6-8 weeks gives your very accurate test results.
3. I've read that being hsv1 positive you get a 50% protection from getting infected with hsv2, is that true?
4. From your knowledge, which you're a member from Astda, published stds books and if it's dr. Handsfield winner for best infectious doctor from the CDC convention, do you think its safe for me to have sex with my wife that's pregnant without infecting her with hvs2 or any other std. Just don't want to infect her.

I just been itchy but no sores or blisters at all. Might be itchy because I'm nervous.
6. Could it be that I could be infected with hsv2 and not have no symptoms at all because I'm hsv1 positive already?

Thanks doctor hook which your dad was a great std doctor too and thanks dr. Handsfield which I watched your YouTube videos and purchased your lastest published book Color Atlas & Synopsis of Sexually Transmitted Diseases, Third Edition.