[Question #3218] Yes or No

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91 months ago
Hello Terri,I have somewhat of an awkward scenario that I would like your expert opinion on. I'm a 34 year old male and I recently finished treatment for HPV. I know it's common and virtually everyone has or has had it. But in regards to that problem it made me think back about something that happened quit a while ago (probably 1-3 years ago). This is been on my mind  lately and I would like your Professional opinion in regards to it.I know I'm going to sound real charming explaining this, but I would go through periods in the past where I would masturbate excessively probably greater than 3 times a day.  Not for very long periods maybe a few days here and a few days there. But I remember something that I really didn't put much thought into at the time: I remembered I would develop what looked like a burn on the right under side of my Penis. I remember it would heal rather quickly , (4-5 days). It would like like raw skin with a mucus coating. For the most part I'm pretty aware of changes that are happening with my body. So I would probably recall if it looked like a herpes blister because I have suffered from oral blisters since I was a child. I would say this happened probably 3-5 times at most and always when excessively masturbating if I recall correctly.But like I said I didn't put much thought into it at the time. So that makes me curious if maybe it this could be HSV 1 or 2.   I did test negative for HSV-2 with both the IgG and IgM Herpes select test.  I tested 6-7 months after my last sexual exposure. But I did test positive for having HSV1.  Which I knew I would because I have suffered from oral outbreaks since I was a young child and usually suffer 2-3 outbreaks per year. I read that its quit rare for someone that is infected with HSV-1 orally to become infected with HSV-1 elsewhere on the body. Is this true?Also, I ready that the IgG misses 8% of HSV-2 positive cases. Is this correct? Will a genital sore resemble a mouth sore? Skin bubbles, soggy skin, etc

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Terri Warren, RN, Nurse Practitioner
91 months ago
it is absolutely true that is very unlikely that once you have HSV 1 in one location you would get it in a new location. 
You say you've had oral herpes for a long time - is that on the inside or outside of the mouth?  Some people confuse canker sores with cold sores. 
But your symptoms do concern me a little.  The thing to do here is to get that area swab tested for herpes, preferably with PCR, the next time it shows up.  I'm not much of a believer in "friction burns" from masturbation. 
And it is true that the IgG test misses 8% of HSV 2 infections compared to the gold standard western blot, yes.
It's probably not herpes but your description of the lesions concerns me a little.  Let's try to get that sorted out.

Terri
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91 months ago
Thank you Terri,

That's the problem that this was so very long ago and since never a problem. I never actually developed lesions just a sore that looked like a cut with bleeding.. It didn't resemble any sort of herpe to my knowledge. I read that the Frenulum on the underside of the penis is common to tear with rigorous sex or masturbation.. I remember finishing and finding blood on my hand on each occurrence.

I'm sure I have Herpes 1 and not canker sores in regard to my oral lesions. So that was the basis of my question. And the testing even confirmed HSV1. Will a genital herpe resemble a cold sore? Blister, crater appearance? I didn't have that. Does that make a difference in your opinion ? What's the likely good that a HSV 1 can be spread to the genitals if it's already surfaced orally? 1%, 5%, 10%?

How many outbreaks would be common in the genital areas annually for HSV 1 and 2?. 

Would restesting for HSV2 confirm my results for HSV2? If it was to come back negative once again?

Thank you

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Terri Warren, RN, Nurse Practitioner
91 months ago
OK, well, this description sounds different to me now.  That sounds less like herpes.  And yes, it would similar to an oral lesion.  I would say the risk is around 1%. HSV 1 genitally recurs about once every other year on average.
In my experience, once the IgG misses an infection in a person, it's misses it more than once.

Terri
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91 months ago
Terri,

Thank you for the stats. If the likely hood on contracting HSV1  on the genitals falls at or under 1% if already exposed that's pretty much a non-issue to me. And I see most published research health journals are in agreement with that stat.

How many of those scenarios have you seen or heard of?.. 

I honestly never saw anything that resembled a herpe on me down there. I'm sure if I had I would for sure have remember it and FREAKED OUT... But I do definitely let my OCD get the best of me most times...

Last question & then we can close the thread...

If the IGG misses 30% of HSV1 and 8% of HSV 2 is it safe to assume my results are accurate...  If the miss rate is 30% again for HSV1 and it picked my HSV1 out as postive (WHICH I AM) ; I'm sure the odds are even better with the HSV2 being accurate if the miss rate is only 8%... (I tested Negative)...  does accuracy increase regarding the fact that I tested nearly 7 months after my last sexual exposure....  That would more then enough time to generate enough antibodies for the test to pick up????.... 



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Terri Warren, RN, Nurse Practitioner
91 months ago
I have only seen one person contract HSV 1 genitally after reporting a history of cold sores as a child.  And I have heard about it happening one other time.
Plenty of time has passed for you to make antibody - no concern there.  We just know that overall the test misses 8% of HSV 2 infections compared to western blot.  We don't have detail beyond that, but there is 92% chance you don't have HSV 2 so that very good

Terri

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