[Question #3144] GHSV1+, May have got GHSV2?
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91 months ago
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HI, I am a white male 35 and I have been GHSV1+ for 5 years. I got it from an oral sex encounter in 2012. My HSV+ been confirmed by Western blot 3 times (A fourth WB actually came up negative for both type 1 & 2 in 2015. I retested in Oct 2017, and again HSV1 +). I get outbreaks that look like small tiny blisters on a red base, usually, a couple spread out across my boxer area; very rarely on my penis, and not in a telltale cluster, that I can recall. Mine almost never hurt or itch, and are often easily missed (often on my butt). I get them frequently and am not on meds. If I have it orally, I don’t get outbreaks.I have taken 8-9 IGG tests for HSV (from Lapcorp) and it never come up positive. On 12/15 I received only oral from a woman I met online (hooker). I wasn’t having an outbreak and figured that my risk to her was low and that she probably had type 1 anyway, so I likely wasn’t putting her at risk. I didn’t notice any lesions on her face/mouth. 10 days later 12/25 (yay), I felt an itch and noticed a red spot on the top of my left thigh, I didn’t pay much attention to it, as I was visiting family then. The next day I noticed that it had turned into the typical herpes cluster, exactly like photos that everyone has seen online. I wasn't able to have it swabbed to see what type it was. It was very atypical from what I normally get. I put a dap or peroxide on it and used Neosporin. Today, 10/30, it is mostly healed, but with very small scabs. My question: How likely is it that I contracted GHSV2 from this encounter? She claims she has no STDs, but didn't respond when asked about cold sores. My concern is that this change in presentation is the manifestation of GHSV2, and that I may be superinfected with both. My previous outbreaks never looked quite like this, hence all the WB.
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Terri Warren, RN, Nurse Practitioner
91 months ago
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So I'm just a little confused. Did you have a positive swab test from a genital lesion that revealed HSV 1?
If your only interaction with the sex worker was receiving oral sex, I am largely unconcerned about your contracting HSV 2 from her mouth. IF someone acquires HSV 2 orally, and that is not a common thing to happen, once it is oral, it rarely recurs and rarely is shed from the oral area without symptoms. I also think that if you acquired HSV 2 from receiving oral sex that the outbreak would be on the penis, not on your thigh. if you get it again, have it swab tested and if you are still concerned, you could have another western blot 12 weeks out.
Terri
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If your only interaction with the sex worker was receiving oral sex, I am largely unconcerned about your contracting HSV 2 from her mouth. IF someone acquires HSV 2 orally, and that is not a common thing to happen, once it is oral, it rarely recurs and rarely is shed from the oral area without symptoms. I also think that if you acquired HSV 2 from receiving oral sex that the outbreak would be on the penis, not on your thigh. if you get it again, have it swab tested and if you are still concerned, you could have another western blot 12 weeks out.
Terri
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91 months ago
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Thanks for your answer. I didn't have the lesions that I get swabbed; they only starting happening after the oral sex incident 5 years ago. They have happened so frequently over the years that I thought that maybe it was type 2 not type 1 for a while. I have had so many western blots to try and figure out for sure and to confirm what I had to different ladies I have met over the years. Also, my erratic work schedule makes getting in to have them swabbed hard. I've just lived my life as though that is what they are; I honestly don't know what else they could be. I get them when I eat too much high arginine foods, and when I get sick or stressed. This change in presentation after so long, right after a new oral encounter is what makes me wonder that something has changed. I hope I'm wrong.
I do have a few follow up questions for you if you don't mind. Like I said, I have taken several IGG tests over the years, and none have shown the HSV1. I have read that they miss about 30% of infections. Is that 30% of individuals' infections, or just 30% of the time? I'm guessing it must be individuals infections, or else statistically, one would have shown positive by now.
Also, which is more likely, that someone with an existing HSV1 infection would get HSV1 in another place after 5 years, or that they might get HSV2 in an area already infected with HSV1?
I do have a few follow up questions for you if you don't mind. Like I said, I have taken several IGG tests over the years, and none have shown the HSV1. I have read that they miss about 30% of infections. Is that 30% of individuals' infections, or just 30% of the time? I'm guessing it must be individuals infections, or else statistically, one would have shown positive by now.
Also, which is more likely, that someone with an existing HSV1 infection would get HSV1 in another place after 5 years, or that they might get HSV2 in an area already infected with HSV1?
Lastly, would having HSV1 change the seroconversion rate to HSV2?
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Terri Warren, RN, Nurse Practitioner
91 months ago
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I think you should have one swab tested, right when it shows up. Just to be certain.
In my experience, it misses the infection most times in an individual, rather than 30% of the time.
It is more likely that you would acquire HSV 2 in a place where you already have HSV 1 than getting HSV 1 in a new location, I think, though this has not been studied specifically. Having HSV 1 slightly delays the seroconversion to HSV 2 should new HSV 2 infection occur.
Terri
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In my experience, it misses the infection most times in an individual, rather than 30% of the time.
It is more likely that you would acquire HSV 2 in a place where you already have HSV 1 than getting HSV 1 in a new location, I think, though this has not been studied specifically. Having HSV 1 slightly delays the seroconversion to HSV 2 should new HSV 2 infection occur.
Terri
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