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Avatar universal

Prednisone and herpes

Hi.

Am a 40 year old female taking prednisone 8 months at 20mg per day now tapering down. Have not been sexually active in about 10 months. In December I noticed one tiny tear on right side labia, it was quite sore not like pimple or sebaceous cyst I would be prone to and I also had yeast infection. Treated yeast infection.  2 weeks ago suddenly had swollen itchy left labia much higher up, white cottage cheese etc. treated again for yeast. This time noticed 3 tiny sore tear/cuts inside on the mucosal membrane, LEFT side. Got very worried. 3 days later went to Infectious diseases Dr (had to wait as it was weekend), he swabbed the sore area, thought it looked 50/50 for herpes. Took blood and urine for other STDs. They all came back neg. Swab was also neg, but he said may have been too late for accurate test. He also did HSV antibody which came back positive.....I asked for which HSV, he said test did not distinguish between HSV 1 and HSV 2. Am confused, Dr says come back asap if another sore appears. He also says Herpes sores usually come back in same location, mine did not. My ex was negative for HSV, (unusual?) now I am afraid I may have unwittingly gave it to him eventhough he has no symptoms. He is getting new test.
MY questions, could I have been HSV  positive for years and years and have had NO symptoms until taking prednisone?
When I stop prednisone is it probable that I will go back to never having symptoms?  Will I be contagious?
How important is it to know if it is HSV 1 or HSV 2? Or the viral load figures that I see people quoting here, what is the benefit?
Why is it that some people are positive and have no symptoms? Can you still pass it on??
It's all a shock, sorry so long! Thanks!
28 Responses
101028 tn?1419606604
it's unfortunate that you had the wrong blood testing done. you needed a type specific herpes igg blood test done, not the non-type specific. Pretty much the provider wasted your time and money ordering the non-type specific test :(  

next time you think you have a yeast infection, don't self treat ( and by all means do not see an infectious disease provider! ).  See your regular doctor or your gyn to be properly tested for yeast and bacterial infections vaginally  before treating.  chronic vaginitis can cause issues with the skin, causing tearing and such so make sure that you are properly treating what is going on. I know it's a pain to go and be seen when you have symptoms when you can buy otc yeast treatments but you are immunosuppressed with the long term prednisone so it's well worth proper testing to make sure you aren't having issues with a strain of yeast that needs more aggressive treatments too.   they can send a swab off to the lab to check.

if you are prone to yeast issues in general, check into either fem dophilus by jarrow or rephresh proB ( forget that company name ).  Both are probiotics that have strains that have been proven with good research to colonize the urogenital tract in females to help reduce vaginitis ( and uti's ).  Unlike some other products marketed for females, these contain strains of "good" bacteria that will do more than just give you healthier bowels.  I swear by the fem dophilus myself and always have at least 1 bottle of it in my fridge to start at the first sign of vaginitis or whenever I'm on antibiotics.  

grace
897535 tn?1295210035
Most likely you had the wrong testing done. As to the swab, "thought it looked 50/50 for herpes" is not possible. A culture (assuming that's what was done) is definitive one way or the other - it goes out to the lab and either comes back positive or negative. Otherwise, if the blood test wasn't typed, then most likely you had a combined test or an IgM, both pretty much worthless for diagnosing herpes.

Best you can do at this point is call your doctors office and ask specifically for your test results. And then most likely you'll have to be properly tested with an IgG type specific blood test.

As to your symptoms, they easily could be related to the prednisone. Did he test for fungal/bacterial infection as well?
Avatar universal
Thanks.....have been reading up here on the difference between the Herpes tests and will ask for the specific HSV test instead.. It was an STD testing clinic I went to and the DR  happened to be an infectious disease specialist. Am not happy with the way he left me not really any the wiser. Years ago I used to be troubled with recurrent yeast infections, they were just constant, but since then I had managed to avoid antibiotics and it's only since been on the prednisone that I have had trouble. I do take acidophilus but I think the effect of the prednisone can overwhelm. I will visit Gyn this week I  feel like I still have a mild yeast not causing discomfort but have tiny bits of that discharge and a bit red there. Will reply when I get more results as it may help others in the same way the post here helped me!
101028 tn?1419606604
most acidophilus supplements do not colonize the urogenital tract. Many of them don't even make it through digestion to colonize the bowels even. you really have to do your homework before buying a supplement.

grace
Avatar universal
Hi Grace,

To update since my last post, I am getting nowhere fast unfortunately. The Ob/Gyn sent off a blood test I specifically asked for the IgG, TYPE SPECIFIC, told her I had the non specific type that came up positive. I am not in the US but surely Herpeselect is available here. She swabbed me for vaginosis and yeast, gave me a diflucan tab plus Flagyl tabs. She just called to tell me the blood test came back but it was just the non specific type AGAIN, saying that I had recent exposure to HSV and that I need to have a swab taken to confirm. I knew when I asked for the specific type test she had not a clue. She says she will call the lab again.
Also I contacted the STD dr where I first went (mentioned in my first post above) I told him what I had read included the link from here from Dr Hansfield etc., and asked him could I get the IgG specific test, not just for the purpose of knowing if I have HSV1 or HSV 2 or both but to get a supposedly more reliable result! He replied by telling me that there is too much info on the internet.....the virus reference lab he sent it to does a combined igg  HSV1 and HSV2 and does not separate out the two. He says the test is very reliable and DOES NOT give false positives!!  He also states "It just says previous exposure to HSV, but does not prove clinical disease!  He says of course best way to confirm is to come back in the first 2 days if I get a lesion to do a swab, but he thinks that as soon as I finish the prednisone that my immune system will stabilize and probably no more outbreaks.
As you can image I am not happy, I hate this wondering, the antibody test he did, he tells me 80% of the population would test positive. I wanted to know for sure so I can deal with it and move on but this way I am still in limbo.  I resented the "too much info on the internet remark he made, it was insulting, since I also tols him the info wa on the CDC website. Please advise.......
101028 tn?1419606604
So you built a brick wall in your back yard and you just go out, talk to it and bang your head against it?  Good grief - I bet you are pulling your hair out about now!!

when the provider gave you flagyl and diflucan, did they properly test you for yeast and bv or just throw both at you?

it's unfortunate that the std doc i so under educated about the blood tests he is doing :(  Unfortunately that seems to be the attitude in general about herpes testing in europe fro what I've seen at the conferences I've been at.    You are right about the testing though, he is wrong.

I hope you get answers soon!  Keep going back anytime you have genital issues for proper testing and hopefully you can get the right blood test done soon. perhaps you can find a herpes support group in ireland that can help guilde you to a nearby provider who does know what they are doing?

grace
Avatar universal
Grace,

The Ob/Gyn did swab me for both bacterial and yeast, she did give me both the Flagyl and Diflucan I guess to cover all and yesterday those results showed just a small amount of yeast nothing to suggest a full yeast infection. I have a lot of cyst/hair follicle bumps many under the skin  they got worse on the prednisone, Dr told me steroids thin the skin so could explain irritation there. She did mention to me about doing a PCR test for Herpes? What is that? Does that seem like a super high tech more expensive test that the type specific?? Should I go for that??
Also. my last partner got tested (the non specific typeof course) he was neg before me and is still neg, hope that is good sign?
Just one more Q please.....All my sisters and my late Mother got cold sores, I have never, how did I miss out? Even as children kisses etc., is it possible to be HSV1 pos for cold sores but never have them??
Will keep pushing that wall! Thanks so much, sorry for all the Qs I have searched but I don't think you have answered these before!
101028 tn?1419606604
pcr is way to do a lesion culture that actually looks for herpes dna in lesions. you have to have symptoms to have it done.  it's more accurate than regular viral cultures of lesions because you don't have to depend on actually growing the virus out in the lab.  

pcr can not be done on blood if your provider was suggesting that. herpes is not a blood borne virus so getting a pcr blood test for herpes is a waste of time.

even the best blood tests still miss 1 out of every 10 hsv1 infections. if your gene pool is such that you are likely to get obvious cold sores ( most folks who get hsv1 don't get obvious cold sores to know that they are infected ) , you very well might not have hsv1 yourself.  At the same time, perhaps you really do have hsv1 orally and got the better family genes that keep you from having obvious cold sores. no way to know at this point due to the less accurate testing you've had done.

your questions are all appropriate - keep asking them!!
Avatar universal
Grace,
I eventually found Ob/Gyn who knew where to get type specific test and unfortunately I do have HSV2. My guess is I have had it years but had no symptoms. It is about 10 weeks since stopping the Prednisone, am told it can take a while for my immune system to return to normal. I have mild outbreaks, thankfully (one blister, some pain down the back of my leg) but are very frequent, about every 2 weeks and usually a day or 2 before my period. Dr agreed this is too much, and prescribed a 3 week course of Famvir. She says I can't take it forever, but I read here of people being on suppressive therapy for a year or more???  How long can you take it? If you stop will the out breaks resume with the same frequency? Also, If I have no out breaks while taking suppressive therapy does that mean I would not be contagious.   Hope you get this with the thread. Am still adjusting to this, am single and don't think I can ever have a relationship again.
101028 tn?1419606604
you can take suppressive therapy for as long as you want. if the provider is being "iffy" about famvir, ask for acyclovir. Plenty of info out there on the safety of its long term use.


The herpes handbook at www.westoverheights.com is a terrific resource for general reading on herpes. Give it a read ifyou haven't already. it's free to read online.

Even though this isn't a new infection for you, finding out you have it is. give yourself some time to adjust to the idea of it all. No reason not to date again when you are ready :)

grace
Avatar universal
Hi,
I am new to this forum. I am also a single women in her 40's(will be 42 very soon) and i  just got diagnosed with HSV 2 3 days ago. I don't remember having any outbreaks like I have read about on-line. I was in a committed relationship for 31/2 years until about 2 months ago. I think I must be asymptomatic or I must have a very mild case because I had no idea I was positive  for HSV 2. I got the test because I thought my ex may have been cheating on me at the end of things so I got tested just in case, not really expecting anything. Wow, was I blown away when the nurse called me with the news. I feel so crazy being a woman in y 40's, a single mom with herpes.Amazing!!!!  How have you been coping with your diagnosis? How has it affected the rest of your life?  I'm trying to deal but sometimes it's kinda hard. I'm a positive person and I'm trying to make sense of things. I like my like a lot and I don't want this to change that. Thanks for your help. Sissy
Avatar universal
HI, thanks for your comment, I still have not adjusted, can't believe it, feel weird at my age, I had no symptoms not until I had to take prednisone for 8 months. Wish I never had to take that med, all I know is that a previous partner is definitely neg and that was before I started taking the meds. Also if its any help not aware of any ex boyfriends having any symptoms which mean that even though I was HSV2 pos for God knows how many years, being asymptomatic I did not pass it on. Just keep your immune system healthy. Even with supplements am still not back to normal. One Dr thinks that once it gets back to normal I may have no more out breaks but not yet happening. If you have no symptoms that is good, though the symptoms can feel like a yeast infection or a mils irritation like using a strong deodrant type soap instead of something like Dove. Not sure at all about a new relationship, this has changed everything. My Ob/Gyn is 'don't worry, it's nothing, just Herpes' well yeah, I won't die but I still hate it, just that one small blister I get feels dirty/ very painful and I feel so contagious, tho when you have even a mild outbreak, sex is the last thing on your mind. Maybe I will feel different as time goes on :(
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