Aa
HSV2?
I found two small bumps on my labia, near the entrance to my vagina, 3 weeks ago. Almost 2 weeks ago I went to an urgent care (I was and am again out of town and unable to see my normal doctor). The urgent care nurse practitioner didn't listen to a word I said. I'm low risk for STDs (1 partner for almost a year and always protected sex before that). The bumps don't hurt, itch, or burn. They are BUMPS, not blisters or sores. They are not fluid-filled (can't be popped). I'm prone to hydradenitis suppurativa, even in the genital area, but those usually - not always - hurt and eventually open on their own or need lanced. I told her this but she quickly said herpes or folliculitis and sent me on my way with a HSV2 test order and rx for Valtrex. I got the test and it came back 3.12, but Grace mentioned this test has a relatively high false positive rate. (I definitely have HSV1 - not sure if that affects the test.) So I took a 10 day course of Valtrex, first 3 doses of 1 mg each for 7 days, then was told by my doc that that is the wrong dose, so 2 doses of 1 mg each for the remaining 3 days. The meds ended Sunday. Now I'm taking once daily Valtrex for suppression and to lower risk of transmission.
Questions:
1. How long should I wait to be re-tested? Re-test with BioKit or Western Blot?
2. How long should an outbreak last with treatment? 3 weeks seems odd for no changes at all. They are still not open sores, haven't spread, and don't seem to be smaller. Just 2 bumps (I need a magnifying mirror to see them.)
3. What next? I can't get to see my doctor until next week. Like I said, this doesn't hurt, itch, or burn, it's just mental frustration and concern about possible transmission to my partner. Could the urgenct care nurse practitioner have overlooked another option?
Thanks for any assistance!
Questions:
1. How long should I wait to be re-tested? Re-test with BioKit or Western Blot?
2. How long should an outbreak last with treatment? 3 weeks seems odd for no changes at all. They are still not open sores, haven't spread, and don't seem to be smaller. Just 2 bumps (I need a magnifying mirror to see them.)
3. What next? I can't get to see my doctor until next week. Like I said, this doesn't hurt, itch, or burn, it's just mental frustration and concern about possible transmission to my partner. Could the urgenct care nurse practitioner have overlooked another option?
Thanks for any assistance!
MEDICAL PROFESSIONAL
I agree with your doctor only in part. Clearly the cysts aren't herpes, and it is true that HSV-1 can interfere with HSV-2 test results. But it still remains likely that you do have HSV-2, based on your blood test -- even though it doesn't explain your symptoms. You would be wise to have one of the confirmatory tests I suggested. Think how you'll feel if someday in the future, a sex partner catches HSV-2 from you and it could have been prevented. I hope you don't have it and you may not -- but you simply cannot know without the additional testing.
Feel free to report back one last time if and when you have had a Biokit or WB test. But I won't have any more comments until then.
Feel free to report back one last time if and when you have had a Biokit or WB test. But I won't have any more comments until then.
I went to my own doctor today. She said she has no idea how a medical professional could look at these bumps and think herpes. She said they are cysts - soak in warm baths to help them open but unless they bother me, it can cause more problems to lance them. Biokit negative. She said HSV1 can screw up HSV2 tests. She recommended no further testing and said if she was the patient, she'd move on with life.
MEDICAL PROFESSIONAL
Your partner's result of only 1.8 most likely is false positive; probably he doesn't have HSV-2 at all. Like you, it will be necessary for him to have a confirmatory test to sort this out. Same deal: start with Biokit, or just go straight to Western blot.
Update: My partner got his test results back. He is positive for both HSV1 and 2. His HSV 1 was 4.8. HIs HSV 2 was 1.8. Did I give this to him? My number is higher. Or is there no way to know? Should he be re-tested or should we just both assume we are positive at this point? Neither of us have ever had symptoms - until these bumps that are probably not herpes anyway.
Definitely don't look like warts. I'll be back in touch with info when I have it. I'm just happy these bumps are unlikely to be HSV, even if I actually do have it. Asymptomatic beats symptomatic in my book! (Though I know the risk of transmission is still there.)
Thanks for your help!
Thanks for your help!
MEDICAL PROFESSIONAL
If an HPV test (from the cervix) is positive, it confirms HPV at the cervix, but it says nothing about whether your skin bumps are warts or not. But most genital warts are obvious -- they look like, well, warts.
I'll be interested to hear the results of your doctor visit and your and your partner's HSV test results. But until then, likely I won't have more to add.
I'll be interested to hear the results of your doctor visit and your and your partner's HSV test results. But until then, likely I won't have more to add.
Thank you! I will do as recommended. My partner has been tested and should get his test results soon. Depending on his results and my doctor's thoughts I'll do a Biokit or Western Blot. Not concerned about the cost so much as getting it over with.
Supposedly the urgent care did an HPV test (they did a pap too) and that came back negative. Frankly I was hoping for HPV over HSV.
Supposedly the urgent care did an HPV test (they did a pap too) and that came back negative. Frankly I was hoping for HPV over HSV.
MEDICAL PROFESSIONAL
Welcome to the STD forum. I'll try to help.
I started by scanning your extended discussion on the herpes community forum. Although I didn't read it in detail, I agree with the central conclusion from that discussion: The bumps you describe are not herpes. HSV lesions would not persist unchanged for 2-3 weeks, and they would have markedly improved (probably cleared up entirely) if they were due to herpes.
From the blood test result, however, it is likely you indeed have HSV-2. Grace is correct that a test value of 3.12 could be falsely positive. However, at that level at least 80% of positive results are true.
In other words, it is likely you have two separate issues here: cutaneous bumps plus asymptomatic genital HSV-2 infection. Whether the bumps are folliculitis, superficial cysts, or something else entirely (genital warts??), I cannot tell. To the specific questions:
1) You can be tested at any time. Research shows that Biokit is a pretty good confirmatory test, and you could start with that. If it is positive, you can stop there, knowing you indeed have HSV-2. If negative, you can then do the Western blot, which is the gold standard for HSV-2 antibody testing. Or you can skip the middle step and go directly to WB, if you can afford it (probably around $150).
2) A herpes outbreak would have started to improve within 2-3 days of starting the drug and would be entirely healed within 7-10 days.
3) What next? Keep your doctor's appointment next week. In the meantime, I suggest you stop taking the Valtrex, which obviously isn't helping. You can always resume it if the additional blood tests confirm you have HSV-2. In the meantime, I suggest you also ask your partner to be tested for HSV-2. His result will help confirm whether or not you likely are infected, and will also determine whether or not you need to take Valtrex in the future to prevent transmission.
Best wishes-- HHH, MD
I started by scanning your extended discussion on the herpes community forum. Although I didn't read it in detail, I agree with the central conclusion from that discussion: The bumps you describe are not herpes. HSV lesions would not persist unchanged for 2-3 weeks, and they would have markedly improved (probably cleared up entirely) if they were due to herpes.
From the blood test result, however, it is likely you indeed have HSV-2. Grace is correct that a test value of 3.12 could be falsely positive. However, at that level at least 80% of positive results are true.
In other words, it is likely you have two separate issues here: cutaneous bumps plus asymptomatic genital HSV-2 infection. Whether the bumps are folliculitis, superficial cysts, or something else entirely (genital warts??), I cannot tell. To the specific questions:
1) You can be tested at any time. Research shows that Biokit is a pretty good confirmatory test, and you could start with that. If it is positive, you can stop there, knowing you indeed have HSV-2. If negative, you can then do the Western blot, which is the gold standard for HSV-2 antibody testing. Or you can skip the middle step and go directly to WB, if you can afford it (probably around $150).
2) A herpes outbreak would have started to improve within 2-3 days of starting the drug and would be entirely healed within 7-10 days.
3) What next? Keep your doctor's appointment next week. In the meantime, I suggest you stop taking the Valtrex, which obviously isn't helping. You can always resume it if the additional blood tests confirm you have HSV-2. In the meantime, I suggest you also ask your partner to be tested for HSV-2. His result will help confirm whether or not you likely are infected, and will also determine whether or not you need to take Valtrex in the future to prevent transmission.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
