Guy with Cold Sore Gave Me Fellatio and Analigus

[fitrunner66]

Doctor,

Today is Thursday and my issue occured on Tuesday of this week.  I'm absolutely paranoid and very concerned - so I'm hoping you can provide some insight for me.

First off, I'm male and gay.  In addition, once or twice a year, I get a cold sore on my upper lip.  For the past two years, I have not had any cold sores.  However, my previous doctor did prescibe me Valtrex for those times when I'd rarely get a flair-up (4 1gm tablets - taking 2 1gm tablets 12 hours apart).  

On Tuesday I hooked up with a guy I met online - he told me he was safe, clean, HIV-.  He came over and it was somewhat dark.  He performed fellatio and analigu on me (I didn't kiss, touch or perform anything on him).  The entire incident probably lasted about 15 minutes between the two activities (about equal time on each).

When he was leaving I turned on the lights and clearly noticed that he had a cold sore on his upper lip, and it looked quite red and nasty to me.  I asked why he didn't tell me about it (and of course, I should have noticed it earlier but it was too dark).  He said it was healing though and he hadn't had a cold sore since he was a kid.  Needless to say, I don't believe him.

Now, back to my situation.  I immediately jumped in the shower after he left and scrubbed my penis and anus for about 5 minutes using soap and water.  In addition, for good measure I wiped hydrogen peroxide on my penis and anus as well (because I had it and it can be used on minor cuts, etc.).   After waking up the next moring (yesterday, which was Wednesday) and about a full 12 hours after the incident - I remembered I had the Valtrex, so I went ahead and took 2 1gm tablets upon waking up and then the last 2 1gm tablets about 12 hours later in the day.

Today is Thursday, I'm still absolutely paranoid about if I'm going to get herpes now on my penis and anus because of the two acts that this guy perfomed on me.  Right now, my penis feels fine, my anus feels itchy.  Your thoughts?

[Edward W Hook, MD]

Itching, particulary anal itching is both a symptom tha can be greatly influenced by anxiety and a symptm that can be adue to an STD.  The determinant of its significance should be established bu visual inspection.  No lesions, no problem.  Hope this helps.  EWH

[fitrunner66]

Thank you for the word on the syphils

Final question - since this past Tuesday, when the incident happened, I've been itchy around the anus and on my butt cheeks.  Maybe I'm just paranoid here again - but what could be causing that?  The symptoms really seem to be an itchy and tingly feeling right around the anus opening and extending up on the cheeks a little bit.

Thank you.

[Edward W Hook, MD]

I would contact him and suggest that he get tested (it is in his interest).  If his test is negative, there is no reason for concern, if it is syphilis the test would be positive. If this cannot be worked out, then watch for a lesion at sites of exposure.  A syphilitic sore would appear within 21 days of exposoure.

let me again emphasize that the comment about syphilis was provided for completeness sake. It is very, very rare for persons to have sores due to oral syphils. EWH

[fitrunner66]

Thank you for your insights.  Now, I'm very worried about the potential of it being Syphillis.  In that regard, what do you recommend?  I will contact the guy and ask if that's what it is - however, I don't expect to get an honest answer.  

Would an STD test include Syphillis?  When should I get tested?  

I'll also read the forum boards related to Syphillis.

[Edward W Hook, MD]

Welcome to our Forum.  You are not at meaningful risk for herpes from the exposure you describe.  Most exposures to person with HSV, even cold sores, do not lead to infection.  In your specific case, you already have HSV-1 in the form or your own cold sores and this infection will have produced an immune response that will keep you from being infected through contact with another person how has HSV-1, even if they have an active lesion.  I would not worry at all about getting HSV-1 from this exposure.

Several other comments.  As Grace has told you , there is no benefit to be derived from your washing or application of hydrogen peroxide. In fact this in itself could be irritating.  Second, there is no known benefit from having take valacyclovir.  Third, and most importantly, there is a small chance that the lesion on his lip was not a cold sore but syphilis. Syphilis of the mouth is VERY rare but it you were to develop a lesion at a site of exposure I would worry about it being syphilis more than HSV.  I say this latter statement about syphilis more for completeness sake than anything else- as I said, this would be very rare.

Finally, I suspect the statement that you have been "exposed" to hepatitis B means that you have antibodies to the infection. If this is the case, that means that you are protected from getting it again.  You do not need to worry about it.

Hope these comments are helpful to you.  EWH

[fitrunner66]

I have scheduled an appointment with a doctor on next Tuesday, as I really need to have a general check-up anyway.  But I am sick with worry and can't concentrate on anything else for the last two days.  I'm angry at the other guy and at myself over this situation.  

Also, several years ago my previous doctor told me I had been exposed to Hepatitis B.  Is there anything that I can or should do about this?  The doctor told me that I was exposed to it, but didn't really give me any guidance.  What are the long-term implications of Hepatitis B for me?  

Finally, I'm 49 and I practice very safe sex overall.  In other words, I don't penetrate others in the anus, nor do I allow that to happen to me.  I pretty much practice oral sex, kiss and have body contact.  I don't do drugs, but I do have two glasses of wine a night typically.