[Question #3509] Next step

35 months ago
I am a 55 yr old white male.  I was told yesterday that I have the herpes virus based on biopsy results taken Tue of a 2 week old genital lesion.  Dermo does not know if it is HSV-1 nor 2 and claims that he can't determine until I my next lesion appears, then have a culture done.  I started valacyclovir on Tues.  I have been dating the same woman for 10 consecutive months, 100% monogamous.  We have had unprotected sex many times - but not oral (her to me).  Last time we had sex was on Mar 11 '18.  I noticed the lesion within a couple days but thought it was a pimple.  It grew, got pussy, hence dermo visit on Tues.   I have not had sex with anyone of any type before dating her since Spring of 2015...again, unprotected, but a different woman.  I have never had a genital lesion before now.  I need to tell my ex girlfriend, but ironically, she just ended things (doesn't know about this).   Can I do a blood test, culture or other test NOW to determine HSV1 or 2 vs wait until the next flare up?  And what is likelihood that it was transmitted to me by her (only person I have slept with in 3 years).
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
You can do an antibody test before the next outbreak but if you are recently infected, it may not show up yet in the test, particularly if you are taking antiviral medicine which you state that you area.  You can do the test and if it is positive for HSV 2, you will know that it is likely an older infection.  If you are positive for HSV  1 only, you cannot know if this is oral or genital unless you have in your life had a cold sore on your lip or in your nose.  Had the derm done a PCR swab instead of a biopsy, the virus could have been identified and typed.  Please let me know what other questions you might have
Terri
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34 months ago
Thank you - I had a login account issue that was recently resolved.  Sorry about this delay.  

My blood tests came back a couple weeks ago - HSV2 IGG 5.73 index; HSV1 IGG 1.04 index / HSV2 IGM screen normal; HSV1 IGM normal.  My physician claims that I have been indeed infected with HSV1 and HSV2 based on the blood tests results.  And as I mentioned, the pathology report from my dermo's biopsy indicated "suspicious for herpes virus infection" from the lab.

Questions

1. Is there any doubt in your mind that I have herpes?
2. Is it common to have both types?   
3. How likely is it that I was infected by my ex girlfriend - the only woman I have had sex with in over 3 years.  My first and only lesion appeared within a few days of our last sexual encounter in March.  I told her about this by the way and she is going to get tested - I do not know the results yet.
4. How likely is it to transmit either to my precious teen daughter by giving her a peck on the cheek to say goodbye in the morning before school?  
5. I have started valacyclovir and intend to stay on it.  I have read that it will help reduce the outbreaks, shedding and transmission.  How effective (%) is it for these, in your view?
6. Other valacyclovir, is there anything else I should proactively be doing or taking to reduce or limit these factors (short of using a condom during sex) ?   Will it have any preventative effect for shingles?  

Thank you


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
It does sound to me like you are infected with both, yes
Yes, it is pretty common to have both types although usually, the HSV 2 is genital and the HSV 1 is oral.
The timing does suggest this partner you described but there is just no way to know for certain unless she is negative in which case it wasn't her
You will not transmit this to your daughter with a peck on the cheek - for sure.
It reduces viral shedding by about 70% and genital to genital transmission by almost 50%
valacyclovir would reduce the chances of you getting shingles but a better strategy is to get the new shingles vaccine.

Terri
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