waiting for herpes results.. question

[juliojunio]

10 days ago I had sex and my partner took the condom off and I did not realize it. I had no physical symptoms, no itching, no bumps and I felt totally normal for six days. On the fifth day I THINK that I cut myself shaving because I was rushing and I am pretty clumsy and careless sometimes. That day I was with my partner and we did not have sex but there was some vigorous rubbing through my clothes.  The next morning(day 6) I had very very painful urination. When I wiped there was blood and I assumed that it was a bad UTI (I've been prone to UTI's and I get them several times a year) but that was the only time I ever saw blood, I believe now that the blood was from the two sores.

The next morning  (Day 7) I realized that the burning when I urinate was not the same kind of burning as when I have a UTI, and I had no need to go frequently and I had some discomfort in my pelvis. I saw my gyn and he did an exam he did no tests, not even a urine culture and sent me home with a prescription for a UTI. I requested to be tested for Chlamydia and Gonohrea but he insisted that if i had either of those he would be able to tell.  He said that if I take the antibiotic i would improve by that evening. I was not satisfied so I made an appointment at hte local health department for the next morning to be tested for a UTI and STDs.  I took a home UTI test after that and it came back negative.

That night (day 7) I noticed that I had two matching bumps on my labia (one on each side) just outside the opening of my vagina.  I washed myself thoroughly with an antibacterial soap and applied bactroban (a prescription anti biotic ointment) because they appeared to be infected. At that point my discomfort improved significantly.  That evening I was with my partner again, again we did not have sex but there was some rubbing through my clothes.

The next morning (day 8), I went to hte health department and told the physician baout the bumps. I told her that I believed that I had cut myself shaving and it got infected. She said that she did not think it was herpes but that she would test it to be sure. She took a culture which was very painful but then seemed to retract her words. After the exam she said that she wanted me to take Valtrex and return in two weeks. This made me think that she did indeed tink that it is herpes.  

She said that if it is herpes and I do NOT take the valtrex that it will get worse with in a few days and if I do take the Valtrex it will clear up in a week. I have decided to monitor myself very closely and wait to see if the sores heal in a few days


I realized last night that Bactroban might not be the best thing to be using on the sores if they are indeed a bacterial infection so I switched to OTC trip antibiotic ointment. They did not appear to improve using the bactroban but I believe they have improved slightly since i've been applying the antibiotic ointment (beginning last night) It has not gotten worse.

My sores do not really look like the pictures of herpes that I see online and they are not visibily oozing although there is a white pus inside the sores. They look more like ulcers with large raw craters in the center. They do not itch but htey hurt  if my clothes touch them too much and it hurts when I urinate if urine touches them.  I have no other symptoms.

I have done some reading about hte cycle of a herpes outbreak and I do not believe that I ever had the blisters and if I did, wouldn't my gyn have noticed during the pelvic exam?

At what stage do the sores begin to hurt? Do they hurt when they are blisters or do they hurt only once they are oozing open sores?

If it is an outbreak and I have two open sores right now, would more blisters appear in a few days or do my current sores just heal?  I am not sure what my doctor meant about the sores getting worse(more sores appearing, spreading or becoming more painful?) if I do not take the valtrex.

Also, is it possble that I cut myself shaving, and the sexual contact (rubbing through my clothes) irritated the site and created a better opportunity for a skin infection?

Is bactroban a cream that should have worked/ made a difference? (I saw later that it was only for two types of bacterial infections)

I had folliculitis once before and I had it examed by a doctor because it was oozing with pus. I was instructed to put antibiotic ointment on it three times a day and that it would clear up in a few days.

I know this is a lot.. I appreciate any insight or help... because I do not get my test results for two weeks.

[gracefromHHP]

if you have discharge, go to be seen and get properly tested for vaginal infections.  

you can have herpes lesions anywhere in the boxer short area regardless of the location of your first ob.  

contracting hsv1 genitally from genital sex has nothing to do with the way you were infected.  it's still hsv1 genitally, nothing at all different about it.

don't assume everything that goes on in your genital area is your herpes reoccurring, follow up with proper exams and testing.  

grace

[juliojunio]

Hi Petal, Can you tell me more about the second out break you had?


I mentioned a few days ago that I felt like I had some tingling -- I think similar to what I had right before the primary outbreak (but it is hard to say because I ignored it believing that it couldn't possible be herpes).

I have some increased discharge and some itching that seems to be associated (I had neither with the first outbreak).  I also have some discomfort in a slightly different location than where I had the first blisters.

I have one very small bright red (almost blood colored) dot inside my labia (the area where the skin is softer/ tender).  Is this a location where blisters can occur?

I know that you said your second outbreak wasn't for 6 months  and that HSV 1 recurrent outbreaks are rare (especially since I am taking valtrex) but obviously I am an exception to the norms because of the way I was infected.  

Does this sound at all like your second outbreak? Were you taking Valtrex?

[gracefromHHP]

perhaps the full study is better but that synopsis of that study wasn't all that useful.   We know hsv1 is a major cause of genital herpes in college age students.  Prior studies have shown that hsv1 genitally is the cause of 70% of all newly acquired genital herpes infections in that age group in the US.  That  study didn't find any hsv1+ lesion cultures so I"m not sure how it's applying to the title of their study very much.   reporting that a little over half of the students in the study were hsv1+ was probably pretty much the same as the hsv1 seropositivity  of the non-sexually active folks in that age group too.  the rates of hsv1 infection are higher in mexico than the US and most folks get it from care givers as children and from kissing as teenagers.

about 10% of folks who have hsv1 genitally do get recurrences more often than the rest.  We don't really know why at this point. Certainly many factors involved including genetics, inflammatory response and especially in females, bv.  Many women on the boards who are having more recurrences of hsv1 genitally, once properly tested for bv and treating it, have less recurrences.  Unfortunately even many providers still believe that if you have bv, you'll have redness, discharge and odor even though studies show that 1/2 of women who have it are asymptomatic which is why proper testing is helpful.

In speaking with Terri Warren over the years, some folks do have regular recurrences of both types even while being on suppressive therapy.   Those folks are the exception to the rules though and it's not something providers see a lot of in general.

grace

[juliojunio]

Thank you

[petal130]

I have genital HSV1 so I can speak form experience. I've pretty much followed what the stats say: I had a horrible primary outbreak in Sept 08, then 6 months later a very minor one. A year later (just a couple months ago) again a minor one.

I'm sure the data isn't skewed - it is factual that HSV1 does not "like" the genital area, hence there are fewer outbreaks and less shedding than with HSV2.

Have you read the Herpes Handbook? It's a great resource with factual information based on years of research/studies on HSV.  http://www.westoverheights.com/genital_herpes/handbook/view_the_chapters.html

Here's an excellent post as well by Dr. Handsfield (also an expert in the field) from the expert's forum:

http://www.medhelp.org/posts/STDs/Recently-diagnosed-with-Genital-Herpes-HSV1/show/969931

[juliojunio]

Hi Grace...

I wanted to share this study with you and ask what your opinion is.. does this say that they did find  HSV1 as being transmitted sexually?

http://www.ncbi.nlm.nih.gov/pubmed/20626123

[juliojunio]

Hi Grace, thank you so much for responding to my previous posts. I appreciate the support.

It has been about one month since my first genital HSV1 outbreak and now I am concerned about future outbreaks. Every time something feels even slightly uncomfortable down there I get nervous that it is another outbreak.
This morning when I woke up I felt like things were a little tingly. But I just don't know if that is my imagination because it is on my mind all the time.

I recently spoke with my general practitioner about how the frequency outbreaks and she told me that the number of outbreaks varies completely from person to person regardless of the type and location.  

I told her that I had read online that people with genital HSV1 much fewer outbreaks and she said something about the data being skewed... something about the number of people having no recurrent outbreaks lowers the average number of outbreaks.

She also said that she has a few patients that continue to have frequent outbreaks despite taking Valtrex.

I know this is silly but do you have any comments regarding what my Dr. said? Perhaps I misunderstood. I'm trying so hard to find peace of mind.  

[gracefromHHP]

we have no idea if daily suppressive therapy reduces transmission of hsv1 genitally.  we don't have a study for a dose either.  we don't even have a study to show if it reduces shedding significantly or not to make it worth taking suppressively for hsv1 genitally.

grace

[juliojunio]

I am on 500mg of Valtrex once a day..since herpes is most contagious in the first year would it be more effective for me to be taking 1000 mgs? (of course I would consult with my dr. but I wasn't sure if it was even worth asking)

[gracefromHHP]

since you didn't have a blood test done at the time of the lesion culture, no way to know if this is a newly acquired infection or not.  At this point, too much time has passed for that answer.

you can transmit hsv1 from genitals to genitals but it's pretty low risk. Less than 10% of all genital hsv1 infections are transmitted that way.  odds are you won't transmit your own hsv1 genital infection to a partner but I know at the moment that probably seems like silly talk to you with your own situation.  

grace

[gracefromHHP]

this person does not need a blood test to confirm a typed lesion culture.

grace

[freeman10]

To confirm it do a blood test too

[juliojunio]

Yes,  I am positive it was from a swab. I did not have a blood test.

I don't believe that I had it prior to this...it hurt and burned so badly..it was unlike anything I've ever felt before. I guess what I was considered mild was the fact that I only had two lesions.

My results say: Herpes Simplex Virus type 1 DNA was detected by real time PCR.  

[petal130]

And you're sure the positive HSV1 result was from a swab, and not blood test, correct? You didn't mention a blood test, so I assume you did not get one. And, if you got a blood test and culture, you'd know from the results of both if this was a new or previous infection.

How you got it though is not important as to how you infect future partners. Genital HSV1 is genital HSV1.

No, the severity has no bearing on future OBs. The fact that yours was so mild could very well indicate you had this prior to this encounter. If you've never been tested before you have no way of knowing.

[freeman10]

Did you test for blood test before the swab?

[juliojunio]

I appreciate everyone's responses. I was not infected from oral sex which is why I am so worried about infecting a future partner in regular sex.

Does the severity of the first outbreak give any indication as to how often future outbreaks occur? Like I said in the first post, my primary outbreak was so mild that the first doctor that examined me did not even see it and the second doctor first said that she did not believe it was herpes.

[petal130]

I have genital HSV1, from my partner who has had oral herpes since his teens (years ago) and we didn't realize it could be transmitted without symptoms (he had never had a cold sort in the five years we were together). My first reaction too was like yours. Now, almost 2 years later, it really has no impact whatsoever on my life. Most adults have HSV1 (orally), so that gives them significant protection against getting it elsewhere. Any future partner would want to be tested for both HSV1 and HSV2 so then you can make informed decisions about precautions should you need to. As well, the frequency of outbreaks is about 1-2 the first year and maybe 1 every year after that. Some folks never have subsequent outbreaks. I can say that mine has followed the norm, except they have been very mild and in taking Valtrex, it nipped it in the bud quickly. As well, genital HSV1 sheds very infrequently too.

I don't take Valtrex suppressively, as it's not been proven to reduce shedding or outbreaks in genital HSV1.

A great resource is the herpes handbook: http://www.westoverheights.com/genital_herpes/handbook/view_the_chapters.html  I believe Terri Warren has a video you can watch as well.

[freeman10]

Did ypu test for herpes IGG to check hsv2?

[gracefromHHP]

we don't have transmission stats for hsv1 genitally. Since it sheds infrequently and so many partners have it orally, it's just too hard to study the same way we can hsv2.  

grace

[juliojunio]

I was diagnosed with a DNA test I think... they took a sample from the sore.

I was referring to him as my partner for simplicity. We had sex twice (stupidly) and I do not know if he has been tested...I am not very interested in communicating with him. As I said..he took the condom off without my knowledge and changed my life forever.

My questions in the last post are assuming that I am coming in contact with someone that is uninfected.

[petal130]

How were you diagnosed as having genital HSV1 - by swab/culture or by blood test?

Also, has your partner been tested to know his own status?

[juliojunio]

Thank you for your responsiveness, Grace.

I tested positive for HSV1 and I feel like my life is over. I have some questions now about the contagion and transmissions.

1. I read that outbreaks and shedding decrease over time. Will my shedding decrease even if I stay on Valtrex and never have an outbreak? (Does somethign about actually having an outbreak cause the shedding to decrease)

2. If a partner touches my vagina and then touches himself, is this a likely way of him becoming infected given that I am on Valtrex and that the type is type 1?

3. If i miss a dose of Valtrex am I making myself more contagious and more susceptible to an outbreak?

4.How long after the primary HSV 1 outbreak heals am I contagious (while taking valtrex)?

5. I am concerned about a partner touching me and not washing his hands immediately and touching other things like sheets, and bedding etc. Can anyone give me any information about this? Like how long does it live outside the body? Is this something that I should be concerned about?

6. Since my primary outbreak was not severe does that have any correlation with how often I shed or the likelihood of me transmitting it to a partner?

7. I read that studies show that women taking valtrex with HSV 2 have a 2% chance of transmitting to their partner with the use of condoms. Since HSV 1 is less contagious during genital contact is it safe to assume that there is less than a 1% chance that HSV 1 can be spread during genital sex with the use of condoms and valtrex?

[gracefromHHP]

it can be.

have you talked to your partner about him getting tested?

grace

[juliojunio]

Yes, I was tested for a yeast infection and a sample was examined for BV and trich.  I have no itiching just pain. I started Valtrex two days ago and there are more blisters now.

The initial blisters are not crusting up but appear to be getting smaller and healing. Is that symptomatic of herpes?

I have some lower back pain and some bowel discomfort now. Is that symptomatic?