HSV-2 offering protection against HSV-1?

[notworried]

I'm a 28 year old female with genital HSV-2 determined by HerpeSelect (I am negative for HSV-1). I contracted HSV-2 either 19 months ago through a partner that tested false-negative, or in fall of 2004 during two protected encounters with one individual whose HSV status is unknown to me. However, I only began experiencing neuralgia approximately 12 months ago. My symptoms: shooting pain everywhere in my body down to fingertips and toes and in my nodes (even underarm nodes), neck and headaches; itching, terrible burning, extreme sensitivity and pain in the vaginal area (hurts to wear underwear or to have a clean sheet skim over the crotch); flu aches and feverishness. To my knowledge I've never had an open blister or sore, which is what made the process of getting a diagnosis exceedingly protracted and difficult. Most gyns thought I was just crazy.

I also contracted hrHPV (probably more than one strain) 19 months ago. Feel like a walking STD here despite all the precautions I have taken.

I am now seeing someone who has oral HSV-1 and is awaiting his results for HSV-2. Here are my questions:

1) Does preexisting HSV-2 definitively protect you against HSV-1? Does it matter where the HSV-1 is located; i.e. oral or genital? I am afraid to kiss this guy because of the severity of my HSV-2 symptoms. I cannot imagine what having oral HSV-1 on top of my genital HSV-2 would be like given that my HSV-2 symptoms are so severe, constant and uncontrollable (see below). If the answer is yes, PLEASE direct me to studies so that I may further educate myself.

2) What is the next step if any for drug-resistant HSV-2? My neuralgia is terrible and occurs 24/7 and is NOT responsive to Valtrex (which I can't take anyway, as it causes explosive digestive problems).

Thanks for any help.

[gracefromHHP]

How was it determined that your all over body neuralgia was due to hsv2?  What other work up has your neurologist done for your symptoms?

grace

[notworried]

I'm certain that my neuralgia is caused by herpes, but I can point to no study or test that proves it. It's the absence of other neurological problems that could cause this (CT scans, MRIs, MRAs of head, neck, back and other exams all clear) that lead me to this conclusion. I know you can't believe everything you read on the internet, but then that also includes forums such as these, but I have read of other g. herpes manifesting with terrible neuralgia as well as known one person who has herpes neuralgia only after an initial (primary) OB. I can only say this is how my genital herpes manifests and I recognize that most others' manifestations are classic OBs. Mostly the neuralgia is from waist down but sometimes it affects the whole body. I forgot to list one other symptom: extreme redness in the upper pubic hair area (same place) with the above symptoms which I assume is where I was first infected.

Does having HSV-2 protect you from HSV-1? And is there anything else I can try after Valtrex? Thanks.

[notworried]

I recognize this is a very unusual presentation of g. herpes, but in the absence of other neurological problems, I can only attribute the neuralgia to the HSV-2, which makes sense since HSV-2 lives at the base of the spine when it's dormant.

My problem is that it's NOT dormant...it's active all the time. Is there any way to suppress this other than -cyclovir antivirals? My main gripe with Valtrex is EXPLOSIVE (and I mean explosive) diarrhea almost as painful as the neuralgia itself. I tried it several times to make sure it wasn't caused by something else.

Also, my gyn mentioned that I could take Valtrex only when neuralgia was unbearable but does this not increase the chance of drug resistance?

But mostly I am worried about acquiring HSV-1 after genital HSV-2 which I can't seem to find any study addressing.

Thanks for any help.

[gracefromHHP]

According to the few studies we have on it, hsv2 protects significantly from hsv1 but not vice versa. In this current relationship of yours, your hsv2 is the issue, not his hsv1.

Have you ever tried acyclovir or famvir?

grace

[notworried]

I have not tried either drug you mention as my doctors put me on Valtrex immediately (I saw two and both recommend that over the others, not sure why), but as they are all in the same class shouldn't I expect the same problems? In fact isn't Valtrex a derivative of acyclovir? Regardless I put in a call to the doc to get it switched.

I know that HSV-2 is more "significant" than HSV-1 and I disclosed my HSV-2 status right away. He got tested because he was formerly in a LTR with a woman known to be HSV-2 and we're still waiting.

A few more questions:

1) I thought herpes (whether 1 or 2, g or o) was supposed to DECREASE in severity over time? MIne seems to be doing the opposite. I was either infected 4 years ago or 19 months ago and my symptoms of late have gotten so much worse in a short time--hence all the testing. Can I expect it to continue down this road or can the tide turn back to being totally asymptomatic? I don't want OBs, but I'd FAR prefer the avg. 4-6 classic traditional type OBs (blisters or sores) to constant neuralgia and flu symptoms. Especially as the red spot that recurs in exactly the same spot every time is certainly painful enough to be an open blister.

2) Do you mind linking me to studies that demonstrate protection against HSV-1 from 2? I could not find anything that specifically addresses this, only the other way around (that 1 might partially protect against 2 but mostly in the decreased severity of symptoms sense).

3) Have you tried vitamins or supplements for your HSV-2 or have antivirals curbed your symptoms significantly?

Thanks again for your comments.

[gracefromHHP]

1- no ob's don't always decrease over time. One study showed that after 5 years of being infected with hsv2, 1/4 of folks had more ob's, 1/4 had less and the rest all had about the same.  It's different for everyone.  

2- I'd have to hunt to find the exact studies and frankly I don't have time this week to do so. You can try googling them to find them yourself or look for them on pubmed.gov. Also the std experts forum has had many posts affirming this too if you just want to search here on medhelp for posts by HHH/EWH.  

3- I am well controlled on the herpes antivirals.  When I'm not on them - nothing I do seems to make a difference in decreasing ob's.  having had hsv2 for 22 years I've learned that it's just easier to take the prescription pills and get dependable control of my herpes.

So why might you have "issues" with valtrex and not acyclovir? Well yes indeed valtrex is an acyclovir prodrug so it does eventually just turn into acyclovir anyways in the body.  Because of the way valtrex gets the acyclovir into your body though, you get more active acyclovir than you do from just taking plain ole acyclovir.  Some folks just don't tolerate the higher amounts you get from valtrex and do well on acyclovir.  certainly worth a try don't you think?  Providers tend to recommend valtrex over the other 2 herpes antivirals because you can take it less often.  The less often you have to take medications, the more likely you are to actually take them.

Have you seen a rheumatologist and a neurologist? Have you continued to follow up with them for all this?

Feel free to ask any questions you might still have :)

grace