HSV Diagnosis

[Bluecow]

Today I received the dreaded diagnosis.  My blood test came back positive today.  I went to see my GYN because I thought I was suffering from yeast/bacterial vaginosis--he prescribed Flagyl, as well as Clindamycin and as a final precaution ordered an HSV blood test.  I am relieved, yet very upset about the official verdict.  I've probably been infected with HSV-2 for at least 30 years.  I have an 18 year old daughter who was delivered vaginally without any issue.  I was married for more than 11 years and never infected my husband.  How can this be? Even though my GYN has checked me regularly for HSV antibodies, I have never received a positive for HSV culture.  My first question is why do I only have periodic episodes, maybe once a year and sometime going as long as 3 years?  I thought that only HSV-1 people were lucky enough to be afforded the relief of being episode free for long periods of time.  I recently started have sex again after being celibate for more than 2 years.  My partner and I enjoy both oral and vaginal sex. Our first couple of weeks involved an abundance of vigorous sex   I experienced my last episode on 11/2 and avoided having vaginal sex with him for 6 days. I'm really concerned that I could have possibly infected him, even though he is not showing any signs or symptoms, at this time.

My doctor has prescribed Valtrex to be taken at the onset of an episode.  I know my body pretty well and can always tell when I'm about go into what I guess is termed as the prodrome.  I usually get an achy feeling in my fallopian tube area, almost always located on my right side.  Do you think that I should take the Valtrex once a day for 6 months or should I go with the suggested Rx that my doctor says will probably work for me?  Also, after 30 years of carrying the HSV-2 monkey on my back -- do you believe that I am still shedding the virus, a lot?  If so, should I take the Valtrex daily to prevent or lower the risk of shedding the virus?

Finally, I don

[Bluecow]

Everyone thank you so much for your comments.  I'm feeling pretty good about myself today.  Hey, after all, my HSV status is here to stay and, more importantly, I fortunate, because I am not HIV positive.  So, today I feel extremely fortunate.  I'm going to talk to my partner tonight, but first, I'm going to ask him what his HSV status is and then I'll share my results with him.  Hopefully, the focus of our conversation will be dominated by what we can do to protect each other, rather than one filled with angst.

Thanks again for all of your comments and support.

[t1234]

Personally, I think you're better off sharing your status
with him asap.

It may terminate the relationship; but there's
no hope for the relatioship if you transmitt it to him, and he finds out the hard way.  Also, in some states, it's a crime to knowingly transmitt a venereal desease and lawsuits are common.

I agree that the problem with herpes is the social implications.
I wish it would be declassified as a veneral desease and accepted by the general public in the same vein as "yeast infections" which also can be transmitted sexually harmless though they may be. But unfortunately thats not the world we
live in.


The 25 percent infection rate figure is for the general population.  I suspect the overall seropositive rate for singles our age is much higher, maybe over 50 percent for females (seropositive rate). That is because  single adults over 50 have been married and divorced at least once and most have had a number of reationships. I know in the last 4 years I have not met a woman who tested seronegative.

Your ex-husband may have had herpes and not known it,(seropositive). However. the F-M tansmission rate is 5 per cent
per year so the odds in the worst case of him getting it from
you was only around 50 per cent in that time frame.  So it wouldn't have been unusual for you not to have transmitted it
to him.

But that doesn't mean your new partner won't get it.

[bluebird05]

You should tell your current partner you tested positive for HSV-2 and that 25 percent of us have it.  Have him get tested to see if he has it...then you can go from there.  If he is mature enough to stay with you and does not have it, you can practice safe sex.  Or, he can get it orally and after it runs its course he will be immune from getting it genitally.  Oral HSV-2 usually never returns or very seldom does....good luck.

[gracefromHHP]

I'm also a bit confused - you wrote that you've been tested for hsv before and never had any antibodies but you think you have had hsv for 30 years? Were you getting regular blood tests for herpes prior to this new + test?  Could you get a copy of your blood test results and post them here?  It would be more helpful.

Your current partner needs to get himself a type specific herpes igg blood test to know his status.  

The herpes handbook at www.westoverheights.com is a terrific resource to learn more about herpes at.  Both you and your partner should give it a read and decide TOGETHER how you want to treat your hsv2 infection if indeed he is hsv2-.  If he feels that daily suppressive therapy to reduce his risk is the best choice and you do too then by all means give it a try.  

grace

[Bluecow]

Thank you all for your comments. I forgot to mention that my ex-husdand was prone to cold sores as a child and that he still gets them from time to time on his upper lip.

I believe that I was exposed some thirty years ago because I experienced a horrible outbreak in my gential area and was told by a county health worker at a public clinic that I had herpes, absent of any kind of culture or blood test, but rather [visual inspection].  I remember being ill for more than 2 weeks and unable to walk without great discomfort due to swelling in my groin area, on both sides, compounded by a bout with a severe UTI infection.  At that time, I was treated with ether be swabbed, topically on my the open sores, along with an antibiotic for the UTI.  I believe I was about 19 or 20 when all of this occured and now I am 50.

I just accepted the fact that I had something veneral, probably herpes, but it wasn't until I started reading this board that it mattered to me what type of HSV I was infected with.  I really don't know why the other cultures came back negative, but my GYN said that a blood test would be the very best predicator, so I now have the clear cut proof that I am HSV2.  My only real problem with this disease is dealing with the social implication of having to share the intimate details of my past with someone other than myself.  I am dreading this aspect, the most.  As I said in my previous posting I don't experience many outbreaks.  Maybe once a year or 18 to 36 months and that is why I was asked your opinions/thoughts regarding suppressive therapy.  My doc says to use the Valtrex, as needed.

Guys, I don't know why, but I have one of those intutitive feelings that my present partner has either been exposed or is wondering how to ask me because about my status.  He made an off the cuff casual statement in jest about herpes simplex. You the kind of joke that causes you to pause.

I don't plan to share my status with him unless I can clearly determine that he is going to be a long-term partner.  We have only been dating [having wonderful sex] for 2 months.

Thanks again for your comments.

[H. Hunter Handsfield, M.D.]

I am traveling out of the country; with apology, my initial reply will be brief.  However, you have had useful comments already (below), especially from GracefromHPP, and I will follow up with more information in a couple days if it seems necessary.  In the meantime, some brief comments:  Your further history below certainly suggests an initial infection 30 years ago, but doesn't prove it.  I endorse Grace's advice that your current partner also be tested; if he is HSV-2 positive, you have no worries re transmission.  If your infection is >30 years in duration, during which time you have had no symptomatic outbreaks, the odds are you won't have any; and it also is possible you no longer have significant asymptomatic shedding.  I suggest you defer any decision on valacyclovir suppressive therapy until you know whether or not your current partner is infected. (In any case, I do not recommend episodic therapy, as your doctor apparently recommended.  Starting treatment after onset of a recurrent outbreak really doesn't help much.  If you need treatment at all, it probably should be continuous suppressive therapy.)  Even if your partner is susceptible, you and he should have a frank discussion about whether or not preventing transmission to him is important; many couples just accept the risk, knowing that effective treatment is available if transmission occurs.  (Of course, this also depends on the likelihood that he might be in future relationships....)

I hope this helps.  Check out the herpes information at the American Social Health Association (www.ashastd.org); and also consider calling ASHA's herpes phone line for in-depth discussion with a knowledgeable counselor.  Also use the search function on this forum to see many other threads that address the same questions.

I'll be happy to provide further information in a few days if you don't get answers to all your questions.  Best wishes--

HHH, MD

[t1234]

The M-F rate is higher roughly speaking about 10 per cent.  Of course these rates are defined as unprotected intercouse on a weekly basis for 1 year.  But of course, none of this equals
the "media hype" on the subject.

This data has been derived, if my memory is correct, from GSK's
Valtrex study as a side project Also, there are others which are on point.

One was published in JAMA, "Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 From Men to Women"

I think there's some good data in it. Just fish around the net.

Unfortunately, little is known about the transmission
rates in populations with few or no symptoms as the studies
or clinical trials were done with persons who had regular outbreaks.

The assumption is  that people with no symptoms still transmit the virus through viral shedding,  and it has been shown with PCR technology that shedding does occur. But the only
way to know what the tranmission risk is via a clinical trial targeting the subject population.

Personally, I was hoping that some HMO such as Kaiser Permante
or the Kaiser Foundation would get interested as there's
not much economic incentive for Drug Manufactures to do it.
If the HMO's are paying for a lot of Valtrex suppressive therapy, it seems they would want to document any situations were the patient may not really need it not to mention the
cost of HSV testing when the patient has no symptoms.

But that's another subject.  I'm glad you're telling your partner.

[Bluecow]

M.D.-HHH,

Thank you very much for your comments.  I don't know if my current partner will become long term, but I am hopeful.  With regards to suppressive therapy, I agree with your comment and am of the belief that if I have an outbreak, I might as well allow my body to go through the process without Valtrex.  As I stated, my recurrent outbreaks are far and few in between.

I truly hope that my HSV decides to lay dormant until the end of time.

Bluecow.

[Bluecow]

You're absolutely right, I'm going to talk to him.  I can't believe that the transmission rate from F-M is that low, and that M-F is high.  Where can I find more information on F-M transmission?

As far as I know, my ex-husband does not have HSV-2, but then we have been divorced for many years, so what do i really know.

I'm still concerned about suppression therapy.  I would like to know if there is a chance of developing an adverse reaction to long term suppressive therapy, such as liver damage or stomach related issues.  Do you believe that I should just continue to allow my body to fight off the recurrences, naturally?  I can't stand the discomfort that accompanies my seldom outbreaks.

[aloha37]

Since 25% of the population is HSV 2 positive and many of them do not know it, it is possible your former husband is HSV 2 positive and does not know it.

You are obviously dismayed to find out that you are HSV 2 positive (by culture), yet you seem pretty sure you were infected 30 years ago.  It seems you are aware of an exposure but never recieved an official verdict in the past 30 years?

Did you think a positive result for HSV anitbodies was less reliable that a positive culture?