Worried for 7 months.

[stressed888]

6 days after protected sex, except for 15 seconds, I was tested & got a "recent exposure" diagnosis of some kind of HSV (combo: neg IGG, + IGM). 4 months later I received only oral sex from the same promiscuous guy (he had no signs of cold sore & SAID he never had one). 7 days later, I went in a hot tub & almost immediately afterward (no washing), jumped into bed w/ him w/ a condom, no oral. 1 day later (8 days after receiving the oral) I began itching down there (a little discharge like a yeast infection too). I developed a UTI simultaneously, which I got medication for. During this time, with a high-magnification mirror, I noticed a whitish, almost canker sore-like irritation only on the inside wall of the vagina in the crease where it borders the perineum. The irritation was about a 1/2" x 1/8" line w/ another 1/8" x 1/8" blotch (no flu-like symptoms). It didn't hurt, not even to the touch. I took a year-old left over prescription of Fluconazole, waited about a day & a half, got impatient then tried Monistat 1 dose ovule. The itching wasn't unbearable & I checked down there everyday & never saw any scabbing. The irritation faded away. I was  itch-free after 10 days (TOO many meds?)

Now, 3 months later I went & got a 10 min Herpes immunoassay gG2 test (intended only for HSV2), it came out negative.

1. Does that sound like the one and only initial outbreak of genital HSV1 from receiving oral sex 8 days prior, or was it more likely an irritated yeast infection from [protected] sex and a dirty hot tub? (also why I got a UTI)

3. Are my chances of it being genital HSV1 greater because I tested negative (existing) IGG 4 months prior? Or are those combination tests unreliable even in the IGG results?

4. It's been about 3 months since my UTI & possible yeast infection/possible initial genital HSV1 outbreak. I have not had any other symptoms since. How will I ever know if I really have genital HSV1 if I never have any other "symptoms" & therefore can't do a culture?

[Terri Warren, RN, Adult Nurse Practitioner]

I see that you posted also on the STD board with Dr. Hook.  I completely agree with his answers.  We are both basically telling you the same thing, I believe.  It may make you feel better to get another HSV 1 antibody test at some point.

Its important to realize that many people in the US have HSV 1 infection, and at some point, if you have a full and active sexual and kissing life, you may get HSV 1.  Its clearly not the end of the world and as Dr. Hook said, if you do get it genitally, it recurs infrequently and is quite benign.  Sometimes, there are tradeoffs in life that we make for richness.  Only you can decide what tradeoffs you will make, but in my opinion, its always good to know what your risks are so you can make educated decisions.  That means getting partners tested - with oral sex, asking about a history of cold sores may be useful, but many people have HSV 1 orally and don't get cold sores.  Isn't it all so complicated???

Terri

[candy171311]

So my husband just recently got a sore on his lip that wouldn't go away, so he went in to the doctor and they said to be safe they took a blood test, sure enough he tested positive for HSV 2, I know that is genital, so I have some questions. I went and got tested and I am negative, so now I am like hmmm.....we have been married for 24 yrs and I have never seen an outbreak or had him complain of an outbreak in all that time. The doctor said it is possible that he has never had an outbreak and that it has laid dormant all these years. Is that possible? Also can he have it for all this time and not give it to me? He is having the bump on his lip cultured to see if it is in fact and outbreak. I know it is also unlikely that an outbreak on his lip is HSV2, but is it possible if he kissed someone that had given oral sex to someone that he could get HSV2 on the lip that way? Just trying to get the facts. Thank you

[Terri Warren, RN, Adult Nurse Practitioner]

Aaaaah, I see.  
You are most welcome
Terri

[stressed888]

Oh I guess I misunderstood Dr. hook's recent statement to me:

"Before I address your specific questions, let's review a few generalities about herpes infections.  First, it is important to realize that as important as HSV infections are, they are just not all that transmissible and in fact far less than 1% of exposures to infected partners lead to infections in un-infected partners."

Thank you very much again for your time.

[Terri Warren, RN, Adult Nurse Practitioner]

Well, its true that if positive you wouldn't know where it was, but if negative, you wouldn't have to worry about it, right?  
I'm not clear where that 1% transmission number came from exactly.  Forty percent of new genital herpes now is HSV 1, but I'm not clear how exactly those two numbers are tying together in your thoughts.  I think your risk was low, anyway.

I think we can decide to involve ourselves in unwarranted social stigma or not, actually.  But clearly, you choice about sexual behavior is quite individual and you must make choices that suit you best.

Terri

[stressed888]

Thank you so much for your response. I posted my question twice because I realized I had not been all that specific with my first post to you. I have never had a cold sore (been w/ two guys ever) and don't believe I ever had any form of HSV (before 7 months ago) since my results 7 months ago were as follows:

HSV I/II IGG: less than 0.9

HSV, IGM I/II COMBINATION: 1.24

I shifted gears and only tested for HSV2 this time because even if I tested for HSV1, I would have no way of knowing where it resided (since I've done some kissing in the last 7 months also).

I went into more detail in my second response with Dr. Hook. Say this guy has oral HSV1 which he probably does & he's, allegedly, never had a symptom. I now understand that transmission from infected to uninfected is 1%. Why do so many people have genital HSV1 then? There's THAT much oral THAT frequently to boost those odds THAT much? What are my chances of contracting genital HSV1 given that I probably never had HSV1? & the oral was a one time thing.

I'm just going to go back to all-around abstinence & wait for Mr. Right. The social stigma with this is too much.

[Terri Warren, RN, Adult Nurse Practitioner]

Have you ever in your life had a cold sore on your lip?  If yes, then it is very unlikely that you would acquire HSV 1 genitally.  

If you already had HSV 1 then yes, the chances would be decreased that you would get it from oral sex, very much decreased!

You could certainly test for HSV 1 again - but DO NOT have the igM testing done, only IgG.  is there a reason you shifted gears and used the HSV 2 test only this time?

Your symptoms are hard to sort out over the internet, could be many things, sorry I can't help more with that part.

Terri