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Avatar universal

Positive culture for Herpes

Hi doctor,

I went to my OBGYN on Monday because I thought I had a yeast infection.  The doctor said he thought it could be herpes and did a culture.  Got the results yesterday and came back positive for herpes.  I have been in a monogomus relationship for the past 12 years and trust my partner completely.  We have been racking our brains on how this could have happended.  I had a full physical and blood test in October for everything including HIV, Herpes 1/2 etc and all came back negative.  My doctor was very casual about everything and will not even answer my questions because he is to busy.  So, I have insisted on a blood test to find out if I have HSVI or HSV2 which I am having done today.  My partner has never had a cold sore or any lesions in his genital area of any kind and we have been together for 12 years.  

We're both going crazy trying to figure this out.  Could he have been positive for 12 years and never transmitted it to me until now?  Do you think it more likely I acquired it orally?  We do have a healthy sex life with both oral and vaginal sex about once a week. I have to tell you that my outbreak has been horrible.  I have had fever, chills, blisters that are incredibly painful.  The doctor did prescribe Valtrex and gave me some Lidocaine for the pain.  I have tried to find a doctor in my area that specializes in infectious disease to help me through this but have had no luck.  There are only free clinics that only see you one day a week and you have to wait in line for hours.  Would it be ok for me to get back to you once I have the blood test results so you can advise me on how to proceed forward.  It is just so frustrating the lack of education and support that is out there for people in my position.  I have tried to get my quesitons anwered by my OBGYN but I have to leave numerous messages and have been told he's at the hospital, etc.  They are a busy practice.  Thank so much and any advice you can offer would help me tremendously.
7 Responses
239123 tn?1267651214
You are right that it is important to know the virus type.  That could have been done (and should have been done) with the culture.  It might still be possible; since the test result apparently has come back only in the past day or so, immediately tell your doc's office (or call the lab directly) and insist that they determine the virus type.  However, the blood test also will do it, although it probably will take up to 3 months to know whether your test result has converted from negative to positive to HSV-1 or -2.

Since you were not previously infected per your October blood test and have not had other partners, the only possibilities as to origin are that your husband has HSV-1 (probably orally) or HSV-2 (probably genital), and that you were infected by either oral or genital sex.  He could have either infection with no symptoms, and many couples have sex for many years before transmission occurs.  Of course from my perspective as an STD expert, I have to raise the possibility that your husband was infected more recently, from an outside sexual partnership, especially if this turns out to be HSV-2.  But that need not have happened.  You are in a much better position than I am to judge whether this is a reasonable possbility or not.  (Note that toilet seats or other nonsexual possiblities are not on the list.  That doesn't happen.)

It is too soon for your current blood test to be positive for a new HSV infection.  Actually, that is good, especially if you cannot have your virus isolate tested to find out whether it is HSV-1 or -2.  You should plan on having another blood test in about 3 months; if negative for either virus type now, then positive later, it will accurately indicate virus type.  In addition, your husband could be tested now, to see which type(s) he is carrying, which also will help sort out both the virus type and the likely source of your infection.

If you have HSV-1, you can anticipate relatively infreqent recurrent outbreaks in the future; 40% of people have no recurrences at all.  If it is HSV-2, outbreaks probably will be more frequent.  However, those can largely be prevented by ongoing treatment with Valtrex or related drugs.

And believe it or not, there is a bright side:  Since you and your husband are sharing the same virus strain, the worst is now over; you won't ping-pong the infection back and forth and need not worry about any significant effect on your sex life, once you are past the pain and discomfort of this first infection.

For excellent online information and personal advice, contact the American Social Health Association (www.ashastd.org).  Their phone counseling service (not toll-free, but well worth a couple of calls) is truly excellent.  Every newly diagnosed person with genital herpes should utilize their services.  Also see the herpes information available at www.cdc.gov/std, www.metrokc.gov/health/apu/std, and/or www.westoverheights.com.

Good luck--  HHH, MD
Avatar universal
Also, ASHA keeps information on herpes-knowledgeable providers.  They might be able to help you find one in your area.
101028 tn?1419606604
You could also just have your husband get a type specific herpes igg blood test now. You could have his results back in as little as 24 hours and would know what type of herpes he has and potentially have your answers that way too.  Might be easier than running around town trying to get another lesion culture and hope that there's still enough active virus to detect.  

Also just wanted to add that the westover heights website HHH mentioned also has a doctors list too to see if any on there are near you if there are none on the asha site.  Also if you don't want to pay the phone fees for the asha hotline - they also have a sti message board that is manned by their hotline folks that you can post for free on too.  

Avatar universal
Thank you so much doctor, this is very helpful.  I have just left a message for my doctor's office to see if they can type the culture.  If they say they cannot, would it be in my best interest to have another culture done now to type?  The first was done on Monday and I still have some pretty severe symptoms.  I could always go to an urgent care center.  I did take the blood test today and from your response, I am assuming it will only show positive or negative for herpes but not which type.  I will contact the resources you provided.  This site is invaluable.  I just wish we have resources available to individuals to get this type of information in our local areas.  To be honest with you, I felt like the doctor did not want to deal with my questions and get me out the door as soon as possible.  I think when it comes to STDs, they just don't want to deal with the other issues that go along with it and maybe are not trained to answer the questions.

Thanks again.
Avatar universal
Your guess probably is right about your doc's office:  some combination of insecure knowledge about herpes, discomfort dealing with STD issues, and worry about the time required.

Yes, you could have another culture now.  However, it might be negative, as Valtrex kicks in.  But if you're still developing new lesions, probably it will be positive.  It generally takes 2-3 days before significant improvement is seen with treatment.  Also, if you have HSV-1, it may take relatively high doses of drug; HSV-1 is less susceptible than HSV-1.  You should be taking at least 1 g (1000 mg) twice a day.

You should expect today's blood test to still be negative for both HSV-1 and -2, becoming positive to one or the other type in a few weeks.

Avatar universal
Hi Doctor,  I just spoke with my doctor's office and they did call the lab and request typing.  It came back positive for HSV 1.  So, I am assuming I received this from my partner through oral sex.  I do have a few follow-up questions if you can help.  Should I continue on the 1GM daily valtrex?  I have been on it now one week and they gave me 6 refils.  I still do have some symptoms but not nearly as bad as a week ago.  Should I now expect to pass this to my partner through intercourse or oral sex or is he less suseptable since he obviously has HSV1 already and passed it to me through oral sex?  Should I be concerned with kissing family members, etc.  I am sorry to ask such questions but I cannot get any answers from my doctor's office other than the test results.  Just want to know what to now expect and how I should handle this and proceed forward.  Thanks again for this great source!
239123 tn?1267651214
That's good news.  If someone has to get genital herpes, HSV-1 is the type to have.  You are right about the source; your partner undoubtedly has oral herpes due to HSV-1.  (There is a slight chance he has genital HSV-1, but probably not.)

First, you cannot reinfect your partner. Nobody ever gets reinfected with the same strain of virus they already are carrying, anywhere on the body.  You and your partner never need worry about transmission back and forth.  It won't happen.

Second, your doctor probably doesn't know that most people with genital HSV-1 do not have frequent outbreaks; 40% have no recurrences at all in the next 1-2 year, and most likely you will not need ongoing suppressive treatment.  Another 40% have only 1 or 2 oubreaks in the next couple of years, and few have onging recurrences.  Genital HSV-1 is quite different than HSV-2, which typically causes 3-6 outbreaks per year for at least a few years.  Therefore, I recommend you take Valtrex for a total 10-14 days, or longer until a week after all your lesions are completely healed.  Then stop.  If you later turn out to be in the minority with frequent outbreaks, you can always resume treatment.  But you probably won't need it.

Third, your infection is genital.  The virus does not travel through the body to other areas than the initial infection.  You will never infect anyone by kissing.

Congratulations on having the "right" HSV type.  All will be well.

Thanks for the thanks about the forum.

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