genital herpes?

[Kathy804]

About 10 years or so ago I started getting a sore on the left side of my back about half way up.  I finally got around to having it checked out, my doctor did a culture and it came back as HSV2.  I had a blood test done that showed I am positive for HSV1 & 2.  My husband also had a blood test and tested negative for both.  Other then the sore on my back I have not had any oral or genital outbreaks.  Everyone I have talked to says that if I have HSV2 that I have genital herpes but I have read that there are ways of getting herpes other then sexually.  Everyone also said that if I have the virus that my husband does and he doesn't.  So here are my questions:

1.  Is it possible to have HSV2 and not have it genitally or orally?   If my back is the only place I have the virus would that mean I am not contagious genitally?

2.  Assuming I do have herpes genitally and I'm getting outbreaks on my back, shouldn't I also get them genitally?

3.  I've read that having the virus in 1 location prevents you from getting the same type in another location.  If I had genital herpes shouldn't that have prevented me from getting it on my back?  Or could it move to my back by itself?

4.  If I do have genital herpes, considering asymptomatic shedding and all, is it unusual that my husband did not get it after all this time?  We have never used protection or avoided having sex at any certain time.

5.  I have read that outbreaks re-occur at the site of the initial infection.  Is this always the case?  

Thanks for your help!!

[Edward W Hook, MD]

As I understand your note, you have had a single lesion on your back that was cultured and found to be HSV-2.  In addition, you have a blood test which indicated you have both HSV-1 and HSV-2.  With these assumptions in mind, let's go to your questions:

1.  Absolutely.  You can get HSV-2 at any site that might have had contact with an infectious lesion.  I have seen HSV-2 lesions on the thighs, the buttocks, the abdomen, the breasts and the back.   If you have the infection with HSV-2 at the site on your back, the chance of you having genital or oral infection with the same virus is miniscule.
2.  The assumption is incorrect.  If you have HSV-2 on your back, you will not have genital HSV-2.   Conversely, if you had HSV-2 genitally, you would not have it on your back.  The culture says it is on your back.  So be it!
3. Correct
4.  The fact that your husband has not gotten HSV-2 is further evidence supporting the idea that your HSV-2 infection is unlikely to be on genitals.  
5.  Yes, recurrence very much tend to recur in the same general area that the initial infection occurred at.

Hope these comments help.  EWH

[Kathy804]

Thank you for that information!!  Just 1 more question:  

Is it possible to have the HSV-1 on my back at the same place I have the HSV-2?