[Question #415] Need help hsv 1 follow up bad anxiety

34 months ago
Follow up to a question several months ago. Had symptoms after unprotected sex and oral. Went to doctors a little late (week or so after onset) four doctors in total saw my groin and said fungal or yeast infection. Not herpes but I had groin symptoms and bad leg pain. Found out girl wasn't the most trustworthy person so I was very anxious. 

They denied me any tests until I left Canada on a trip and at four and a half months post encounter tested negative for hsv2 and positive for 1 on an IGG test. I paid for it myself as doctors here would not give it to me. 

Both of my parents have had cold sores many times in their lives, and I have never had one I can remember at least. Thankfully I was negative for all other stis. I have always been scared of HIV and tested neg at 3,8 and 10 weeks which doctor told me to put behind me. I did not have any flu like symptoms. Just sore spot in groin, itchy rash and leg pain. 

So what should I do? Assume I have genital herpes type one? Or does it sound like an oral infection? 

Should I tell previous partners?  I have already told a girl I have been dating for several months and she still wants to be with me and I want to protect her. She lives in Canada and has never had a herpes test so she might even have type one. 

How upset should I be?  Is my 4.5 month IGG for type two conclusive? 
Any advice would be great as I have an obsessive personality and want to believe this isn't a huge deal. Thanks. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
If four different doctors looked at you and said your symptoms (or groin) had a fungal infection, then I would believe that.  And that is reinforced by the negative HSV 2 test that you done at a completely appropriate time frame to reliably detect HSV 2 infection. 
I'm not clear about the infection rates for HSV 1 in Canada, but the majority of the US Population between 14 and 49 have HSV 1 infection and even more people over the age of 49.  It normally is an oral infection but could also be genital.  With both parents having cold sores, I might bet my money on an oral infection, but without sores in either location, you cannot know for sure where in your body the infection lies. 
I would definitely not jump to the conclusion that you have genital HSV 1 because of whatever symptoms took you to the doctor since they felt it was fungal.  I think your symptoms and your HSV 1 result are completely different issues. 
I don't think you have any obligation to tell previous partners, no. 
Your 4.5 month negative result for HSV 2 is conclusive at 98%, compared to the gold standard western blot.  That's great.

Terri
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34 months ago
Thank you for your reply. I actually had to do a test in the states while I was on vacation and it cost me money so it's not really feasible to test again as I was unable to get one around here.  My concern is that I might have went in too late after my symptoms initially. I still had a red groin rash, but I had a single sore spot that was mostly gone when I went in. And like I mentioned left leg pain. No flu symptoms. 

1)I read on medhelp dr hands field said hsv 1 gen is rarely passed through sex? If I actually did have this would it be more likely through oral sex and not genital sex?  

2)i will be unable to retest for hsv2 which was less than .90 at 20 weeks and four days, so I can be confident in that result? 

3) I am dating a female who I was honest with about everything from the start she has been tested for everything except hsv since Canada doesn't test. From protecting her perspective are condoms necessary regarding my hsv 1 not for sure knowing if it's oral or gen? I had a groin rash in October and went and was once again given fungal medicine and no other symptoms in the last six months. should I avoid giving oral? 

4) I read that hsv1 oral or genital is more common and reoccurs less and sheds less as well? So the fact that this has made me quite depressed and anxious is that an overreaction? How upset should I be? 
Anything else I should do moving forward?
5) last question, if things don't work out with the girl I'm seeing how would I discuss this with a future partner? Say I get cold sores? Have hsv 1? Say nothing? (Which I don't think I could do) it's just frustrating because I went out of my way so hard to test for this and almost no one, especially in Canada will know they have this. 

34 months ago
Also one other question. Would me having hsv1 in any way effect the result of my hsv2 test? I can deal with having one but I would be very upset with 2. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
It is true that HSV 1 is rarely transmitted via intercourse, correct.  I'm not clear that there is much of a difference between risk of you receiving oral sex or having intercourse in terms of HSV 1 transmission.  HSV 1 does like the mouth better, so perhaps a slightly greater risk there?
I do not believe you need to retest at all for HSV 2.
If you want to be ultraconservative about this, condoms would reduce the risk of transmission if you do have genital HSV 1 but the risk is already really low - your call.  Again,you have to decide about risk.  Would she give up receiving oral sex for the small chance you might transmit HSV 1 to her genitals from your mouth?  Again, your call, and hers but if I was given that choice, that would be a no brainer!  Some things are just worth a little risk ;-)
HSV 1 is so common - I don't think you should be depressed or anxious about having this - most people do have this.  Yes, HSV 1 genitally occurs less and shed less than oral HSV 1.
I hear your frustration about knowing this now and other not knowing because testing is not readily available.  You could ask partners if they get cold sores, if they do, then you are on a level playing field.

Terri

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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
No your having one would not influence your HSV 2 result.  We know that people who have HSV 1 take slightly longer to seroconvert to HSV 2, should they be infected with HSV 2, but  you have certainly waited long enough for serconversion to happen (become positive on the blood test) taking into account that you have HSV 1 already.  No worries there.

Terri
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