[Question #1882] Post outbreak itching

43 months ago
Hi, 

 I'm a 48 year old woman and I've had genital herpes for over 25 years and have been in a monogamous marriage for the last 20, and haven't transmitted it (at least not yet!) to my husband, yay! I got an outbreak (in my butt crack) that started about three weeks ago.  It wan't too bad, and I took acyclovir for it, and it healed up, with the scab coming off probably a week or so ago.  But I have had persistent itching at the site, frequently throughout every day.  My question is, am I still potentially contagious?  I've been wearing my underwear to bed so hubby won't have contact with the site when he spoons me, but do you think vaginal intercourse would be safe at this point, if he stays away from the butt crack?  

Thanks so much!
Carrie
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
Well, that's the $64 million question and I have no good answer for you. It's possible that you are still shedding virus, but there is no way to know for sure at this point without swamped testing the area. You do know don't you you that be infectious even when you have no symptoms whatsoever.  I'm wondering if your husband has ever been tested in the past to determine if he is actually infected or not? The test you would want to use is the type specific IgG antibody test. If your husband happens to test positive, You would be able to stop worrying about transmission. I believe I hear you saying that he has never had any symptoms, but that doesn't mean he's not infected. Let me ask– do you take daily antiviral therapy? We know that people who take daily antiviral therapy are about half an is likely to transmit herpes to the regular partner as people who do not take daily therapy. But even when people take daily therapy, On average, they shed virus I'm about 7% of the days. I'm guessing that over 20 years of marriage, your husband has probably been exposed to this virus multiple times. If he tests now and is negative, the chances of him becoming infected from here on out, are really very small. We know that when people are in long term relationships where one is infected and the other is not, the likelihood of transmission actually goes down overtime. It appears that the person who does not have herpes infection, builds some sort of immune response that helps to keep them from becoming infected. I think it would be beneficial for your husband to get tested if he has not been tested so that you can relax more about transmission if he happens to be positive. In answer to your question "am I potentially contagious", the answer is yes you are potentially contagious but you're potentially contagious at times when you have no symptoms at all. It sounds like you're doing your best to avoid any kind of sexual contact when you're symptomatic and that's great. But there are times when you shed virus when you cannot know that you are sheddiing virus. Is your husband is concerned about transmission as you are?

Please let me know what other questions you might have about herpes in your relationship.

I am now dictating responses on this forum so if you see a word that makes no sense or is spelled incorrectly please know that it is due to new dictation. If you have questions about my meaning please do not hesitate to ask

Best
Terri


---
43 months ago
Thank you so much; that is very helpful.  No, I'm not on daily antiviral therapy.  I've just been very, very conservative over the years.  I knew about the possibility of asymptomatic viral shedding, but I had no  idea it was as high as 7% of the days, wow!  I was an STI health educator many years ago, but it seems that there is a lot of new information that hadn't reach me  in the last 20 years.  

That's also a great suggestion to have my husband get tested for antibodies.  What would be the exact name of the test to request from his doctor?  When you say type specific, do you mean Herpes Type II IgG antibody?  

Thanks again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
Yes, that is exactly what I mean.  And whatever you do, don't do IgM testing please 
It's OK  - many many health care providers give patients horrible advice and information about herpes!

Terri
---