unsure

[trbrown]

hi, i've recently had unprotected oral sex with a guy about 17 days ago. don't know his history as this was a one night stand. this didn't last long, maybe a few minutes, and he did not ejaculate. also, i was touching him prior to that. 2 days after i began to fell a burning sensation on the tip of my tongue, roof of my mouth and back of my throat.  there are no visable sores. aday later felt weak and tired for the first part of the day. we also attempted anal intercoarse which did not work. slight penetration but mostly just skin contact. about 5 days later i noticed that ther was a slight rash around my anus.these symptoms have be going on for 2 weeks now with no increase or decrease in severity.  although at times it seems to increase during the day. when i wake up in the morning it seems to be the least servere. currently i've been taking 500mg of valterx daily for suppressive thearpy for cold sore on my lips. after the first sign of burning i increased my dose to 1000mg twice daily. this did not seem to help one way or the other. i went to my family docter who prescibed 500mg of famvir twice daily, which also did not help. she seemed to think that it was herpes but was unsure why it wasn't getting any better. she also gave me a shot of an antibiotic. she ordered a bucnch of test to see what was going on.haven't been tested prior to this. during this stressful time my prior cold sores on my lip appearred briefly but susided quickly. i haven't been eating due to the stress and have lost some weight due to that fact.recently,yesterday, noticed small red bumps on back of my thighs where there was no contact. could it have spread to this area? is it possible that it is herpes that is resistant to the drugs? could i've been infected with hiv and herpes? would an hiv infection from this encounter, or prior encounters with others, weaken my immune system as to cause a prolonged herpes reaction? what should be my cousre of action at this point? thanks for your help.

[Edward W Hook, MD]

Valacyclovir resistant herpes occurs in less than 1% of patients and, as I said, is otherwise similar to other herpes infections.  As you you having HIV, no reason to think this is the case.

We get many questions about whether use of antibiotics or other illnesses might somehow modify that manifestations of STDs, including HIV on this site.  The answer is most often no, as is is for you - the drugs and other issues would not change your response.

If you have recurrent cold sores, you have HSV-1.  HSV-2 hardly ever causes cold sores and when it does it rarely recurs.  Finally for lesions to occur in place where there was no contact makes herpes almost certainly not the issue.  AS I said before, you need to stop worrying and take care of the problem.  The way to do that is to seek evaluation.  Again as I said, in your case if the rash is still there, I would think a dermatologist would be the best bet.  EWH

[trbrown]

Thanks for the response and sorry about my impatience, but your right, it is eating at me. How rare is herpes resistant to valacyclovir and related drugs? And what about the fact that while attempting anal sex there was slight/partial penitration? Could the fact that i have hsv1 on my lip (and/or hsv 2 on my lip, remember i was never tested) and been taking suppressive thearpy be the reason for the prolonged burning sensation without typical sores/blisters? Meaning might my symptoms appear diff. due the the previous anti-bodies in my body and/or the drugs? Also i did see a docter and she seemed to think that it was herpes. Would herpes react in this manner if my immune system was compromised due to an hiv infection? I apologize about all the quetions but some more insight would help ease my mind. Thanks a million Dr. Hook.

[Edward W Hook, MD]

Your post and impatience both suggest that this is eating at you.  I fear that your anxiety has gotten the best of you.  Did you get HIV from your oral exposure - NO.  It is vanishingly rare, if it happens at all.  

As for herpes, again no.  The absence of response to therapy, as well as the lack of lesions suggests this. BTW, valtrex and famvir work the same way.  To take one drug expecting it to have a different effect than the other is not a good use of your time or money.  There is  herpes resistant to valacyclovir and related drugs but it is very rare and typically resolves in the same fashion as other herpes infections.  I would suggest you see a health care provider (possibly a dermatologist if that is easy) and have them take a look.  That is the best way to resolve this.  EWH

[trbrown]

i understand that you can't anwer questions about hiv in this forum, but could you tell me the possibility of my symptoms being a herpes infection? thanks again.

[trbrown]

any ideas?

[trbrown]

hi, was wondering if you had a chance to review my concerns. just very anxious at this point. any help or advice would be great. thanks for the help.