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Avatar universal

Herpes Diagnosis

Doctors, I had condom protected sex with two different street prositutes in September 08 (yikes).  About three weeks later (early october) I had unprotected sex with two different women whom I have known for a couple years.  About 4 weeks later (Early November) a small red bump appeared on my penis shaft.  A day later another bump appeared next to the first one.  After about three more days the two bumps fused into a larger one with the center being slightly open.  After showering with hot water the tip of the bump would turn whitish in color for a short time.  After another 5 days (about 10 days total) these bumps went away but immedaitely 5 new ones appeared starting about an eigth of an inch to the right side from the previous bumps. These were smaller and ran in a single straight line all very close to each other.  These bumps had little black centers.  After about 10 days these 2nd round of bumps went away but a discipating red scar remained for about 3 more weeks.  I had no pain whatsoever, very little itching during the entire episode, and no fluid or scabbing over.   Excatly 2 months later I had another outbreak that occured in the same location and followed the same pattern as the first described above.  I got a culture done through my dermatoligist wihtin 12 hours of this outbreak and the result was negative.  Lab reports:

-July 07 HSV1 ab Specific IgG >5 and HSV2 Ab Specific IgG 0.02  
-August 12, 08 HSV1 ab Specific IgG 3.76, HSV2 Ab Specific 0.02,  HSV Ab w Rflx IgM not detected
-October 24, 08  HSV1 ab Specific IgG >5, HSV2 Ab Specific 0.10
-May 5, 09  HSV1 ab Specific IgG 4.57, HSV2 Ab Specific >5.  
-Also May 5, 09 VZV IgG 2.00 OD ratio, Positive results suggests recent or previous infection with Varicella Zoster
Virus and Imply immunity.

Does the increase in the HSV2 to .10 in October and then >5 in May's lab result defintively mean that I do in fact    
have Herpes?  






6 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the STD forum.

Yes, you have genital herpes due to HSV-2.  Many people on this forum post atypical or confusing test results.  That's because those are the test results that are confusing.  However, in your case the test has worked exactly as it is supposed to do.  Your genital lesions clearly were herpes and the conversion of your test from negative to strong positive shows the HSV-2 as the cause.  The culture from the recurrent lesion was falsely negative -- which is pretty common, even when the lesion is only a few hours old.

As a person with a newly diagnosed case of genital herpes, undoubtedly you will have lots of questions.  Before you ask them here, please read some excellent information on the following 3 websites:  The American Social Health Association (www.ashastd.org), CDC (www.cdc.gov/std), and the Westover Heights Clinic of Portland, OR (www.westoverheights.com).  Disclosures:  Dr. Hook and I are on ASHA's Board of Directors and NP Terri Warren, who moderates the MedHelp Herpes Forum, is the owner/director of WHC.  After your reading, feel free to return here if you have 1 or two BRIEF follow-up questions.  Or you could get Ms. Warren's advice on the herpes forum; or use the herpes community forum, which is moderated by some expert herpes nurse/counselors.

Good luck--  HHH, MD
Avatar universal
Thanks for the information.  Obviously not the answer I wanted but was what I expected.  Is it more likely that I contracted this from two condom protected encounters with the prositutes or unprotected sex with the other two women?

I've read your recommnedations that is is best to inform past partners so I am trying to get up the courage to share this with the two woman I had unprotected sex with a few weeks prior to the episode.  These woman are friends and this is not easy at all.

I am trying to let this all sink in and am quite upset.  I have read that this is a common condition and in someways not a huge deal but picturing a good life with a nice woman is quite difficult these days. Just feeling that I really really messed up and this will greatly impact my future or lack of future relationships.

Lastly, What are the chances of transmission using a daily antiviral but no condom compared to a daily antiviaral and condom use?

Thank you
Avatar universal
Can you comment on the above thread please?  Thank you
79258 tn?1190634010
Well, I'm not a doctor, but I have herpes, and I like to think of myself as "a nice woman". ;-) So I'll concentrate on the social aspects of your questions, while you wait for Dr. Handsfield's response.

First of all, I doubt this will affect any future relationships any more than you let it. One in four or five adults has HSV2 (though admittedly most don't know it). That puts you in some mighty fine company, and it should help you feel a little less "different".  But if you don't feel comfortable approaching new partners right now, you could try a herpes dating site. I can't speak from personal experience, but it seems to me that would let you get your feet wet talking to other people who can relate to what you're going through. Then you can branch out as you feel comfortable. Or not, who knows. Maybe you'll meet the love of your life there.

As for telling your friends, well, it seems likely that you contracted herpes from one of them, rather than from one of the sex workers. Usually a first outbreak is within a couple of weeks of exposure, which seems to put it squarely in their court. So check out the links Dr. Handsfield provided, read the herpes handbook on the Westover Heights site. Post and read on the community forum. Then talk to your friends, and share what you've learned. Remember, herpes is hardly the end of the world. It's more like a head cold, if that. I can think of about a zillion worse things ;-)
239123 tn?1267651214
MEDICAL PROFESSIONAL
Sorry for the delayed reply to your follow-up.  I missed it somehow.

As always, Monkeyflower has useful advice.

I cannot judege which partner you might have caught herpes from. The timing of your symptoms and blood test results is most consistent with catching the infection from either of your two personal partners in October, i.e. not one of the commercial sex workers.  But I see no way to distinguish which.  You could speak with them about past herpes symtoms and they could have blood tests.  In any case, it seems you are obligated to inform both of them.

As far as preventing future transmission, that's too complex for me to address with the level of detail you need.  The basic elements are condoms, avoiding sex during symptomatic outbreaks, and taking antiviral therapy to reduce asymptomatic shedding of the virus -- in addition to routinely informing partners.  Deciding which methods or combinations of these will work best for you is why I recommended several sources above.
Avatar universal
Thank you Doctor and Monkeyflower.  I very much appreciate your feedback.  Life goes on.   I am beating myself up soooo much emotionally but realize this is precisely what I really need to address, the way I deal with situations in life.  I have been told by my therapist as well as a close friend who has had Herpes for 20+ years that the bigger issues for me in any future realtionship is the obessiveness and anxiety.  The consensus seems to be that these will far outweight the Herpes in impacting future relationships!  I am trying to see this situation as a wake up call to focus and improve my life as I have so much going for me.  Easier to say than feel I tell ya that which gets right to the heart of the issues I need to address now.  Also, I wanted to comment on the University of Washington!  I have had dealings with the Foot and Ankle Clinic where I was literally cured from a long lasting and debilitating physical problem in the past.  You guys work at an awesome facility!  I never encoutered a hospital that is so compassionate.  That was my exprience then as it is with you now.  Again, thank you so much as your expert feedback is a life-saver.  I can not thank you enough for the shoulder to "wimper" on and get some TLC with facts!!!  P.S.  Monkeyflower, I have checked out a couple Herpes sites and it is helpful to see the diverse group of people there dealing with this.  A lot of very beautiful woman there!  Perhaps, this will make me focus more on what I really want and move out of this "it's all about sex" mentality.  What a waste of a life and beauty that would be to let that rule my life for the remainder of my existence.  Well, I am rambling a bit and this is not a place for emotional novels so goodbye and thanks!!!  See you on the forum.  
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