I have been unsuccessful in searching the literature to find answers to my questions re: HSV-2. I'm hoping you can answer my questions.
I am in a relatively new relationship. My partner and I are in our mid 40's. We both underwent STD screening, and were found to be negative for GC,Chlamydia,syphilis and HIV. Neither of us had a history of cold sores or genital sores,therefore,HSV screening was not done. Seven days after unprotected vaginal intercourse and oral gential contact, I developed unilateral labia minora itching, burning and tingling sensation, severe extravaginal pain with urination, progressing ot labial swelling/skin slouphing with exudate and one small painful small papule. No evidence of vescicles, ulcerations or crusting.
Due to symptoms suggesting HSV, I was started on acycloivr until test results were available.
Lab results: UA neg, wet mount:neg, clue cells: neg,
HSV PCR:neg, HSV1/2 IGM:negative, HSV1 IGG:neg, HSV2IGG:neg,
3+ lactobacillus on genital culture.
When my provider found everything to be negative, I was empirically started on Keflex for treatment of suspected gential infection and within 24 hours my symptoms had improved significantly, and in 48 hours most sypmtoms resolved. I then dicontinued the acylovir. I will be retested HSV1 IGG and HSV2 IGG 3 months after my initial ? outbreak. My partner was tested and HSV1 IGG: neg HSV2 IGG positive.
My educated guess is that I clinically had atypical symptoms of a primary outbreak of HSV. I was most likely tested too early to develop antibodies. My partner has never had an outbreak, therefore, HSV was transmitted via aymptomatic shedding. I was taking acyclovir for 48 hours prior to starting antibiotics, so I may have improved on antiviral therapy and not antibiotics.
Assuming my educated guess is correct:
1. If I test positive to HSV2 IGG in three months and my partner is HSV2IGG positive: what precautions do we have to take when there are no signs of an outbreak i.e., condoms, oral sex, hand to gential contact?. Can you keep reinfecting each other in different sites?
2. Can HSV2 infect the oral mucosa and lips.? (My partner has complained of chapped/dry lips but no hx of lesions)
3. Is there a role for suppressive therapy in HSV2 in concordant couples for the peace of mind of decreasing outbreaks/viral shedding?
4. If I test negative to HSV IGG 1 & 2 in 3 months, and since my partner has never had a known outbreak, it would seem appropriate that he would use suppressive therapy with the use of condmens to reduce risk of transmission. Please coment.