Hello,

I am a female with GHSV-1 for over 6 years (severe primary diagnosed by culture). I typically get 2-3 outbreaks a year. Some of these are minor, some are more severe. I do not typically take suppressive Valtrex.

 I had protected sex (3 times total) on 30 June with a new partner who was quite large and so there was irritation and possible tearing. There was so light rubbing of genitals for roughly 30 seconds that was unprotected.

4 days later I had what I thought was a GHSV-1 recurrence, with two blisters near the top of the inner labia minora. Prior to this I had the prodrome on leg/back pain and tender vulva. These were beginning to heal (I took 1000-1500mg Valtrex a day once the outbreak began). I then woke on day 9 to find roughly 20 tiny pinhead sized white blisters on either side of my inner labia minora. I treated these with bactine (not a good idea I guess). By the next day the blisters had worsened, though were not painful, and I went to my OB/GYN to get them cultured so I could rule out having acquired hsv type 2. By this point I had been on Valtrex for roughly a week (1000g a day).

The culture came back negative for both type 1 and 2 (as did my IGG (too early to detect) and my IGM though I realize this is unreliable). My OB/GYN said that if it were a new infection it would likely have picked up the type-2, regardless of Valtrex, and that this was likely a ghsv-1 recurrence.

During this period (the evening of getting the Swab, I started to have a yeast infection (later confirmed by my ob/gyn when I showed her a photo at my next appointment).  I haven’t had a yeast infection since age 19, so I was convinced this was also a symptom of hsv-2.

I asked the partner to get tested for HSV-2, he came back negative (<0.1) and he was tested 5 weeks past his last protected sexual encounter: so negative at 5 weeks. He has said he has never had symptoms of herpes, only that roughly 8 months ago two women he was with had yeast infections after having sex with him.

I might add that I had convinced myself prior to finding out his negative results that I did have type 2 herpes, and had stopped eating, couldn’t sleep and had to be prescribed an anti-anxiety medication to calm me down, so I am sure I made whatever was going on much worse by being so run down physically and emotionally.

My symptoms started to abate (but a week later, so 3 weeks after the original encounter) I again started to see little red bumps appearing on both sides of my inner labia minora. I went to the OB/GYN on day 2 of this happening, she said it just looked like irritation but did a culture in any case. The following day the area (all inner labia minora on both sides) again had broken out in tiny pinhead white blisters/pimples (again, not painful to touch) and the entire area was red and irritated. As my OB/GYN was on vacation, I went to an urgent care and got a PCR HSV swab (day 2 of lesions appearing).

Both the culture and PCR  came back yesterday negative for type 1 and 2. Knowing I definitely have ghsv-1, I would have expected it to at least come back positive for type-1.

At this point I thought, ok maybe some weird yeast infection with blisters/contact dermatitis type lesions(not typical, but possible). The redness and irritation is still there a week later.

However, I woke early this morning to itching near my vaginal entrance, and again to multiple blisters (inner lower left labia minora where I usually (though not always) get ghsv-1 recurrence). This is the same area that was swabbed by culture and PCR last week when I had the previous lesions. I am pretty sure this is a definite outbreak. On top of that the whole inner labia is red and irritated.

Based on all of this, I have the following questions

a)      How likely is this to be a new hsv-2 infection given the encounter, given the partner is negative at 5 weeks from his last protected sexual encounter and has never had symptoms, given I have negative cultures and PCR,  given the extensive and recurrent for 3-4 weeks nature of the lesions (bilateral blisters/lesions on labia minora), but also given I had prodrome before the original outbreak

b)      Would 1-2 weeks of Valtrex affect the Culture/PCR swabs : could they produce  false negatives? And how reliable is the PCR hsv-2 negative?

c)       Have you heard of GHSV-1 recurrences being so extensive after such a long period of having the infection (6 years)? Is it possible it’s a recurrence and something else (bacterial infection)?