[Question #4700] HSV 2 Risk

26 months ago
Hi there,

I currently have genital HSV 1 and am afraid I may have contracted HSV 2 genitally as well. I engaged in penile-anal contact with another man on Dec. 8 and over the last week I've developed symptoms similar to when I had my first outbreak after being infected with type 1 about five years ago ... sore legs, a very minor sore on my penis, feeling fatigued, swollen groin lymphs, etc.

What are the chances that I have contracted type 2 with type 1 in the same area below the waist? Do I have any immunity at all against the second strain? Right now, I know I'm in the dark test wise (4-6 weeks for antibodies).

Thanks in advance for your time and expertise.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
While it is possible that you have both HSV 1 and HSV 2 genitally, that isn't common.  Did you have the sore swab tested?  If not, and it is still there, you should have it swab tested right away and ask for typing if positive.  You actually don't have "immunity" if you have HSV 1 first.  If you had had HSV 2 first, you wouldn't acquire HSV 1 subsequently.  If the sore is gone, you are correct that you are in the "dark " period - however, you could test earlier than 6 weeks and if positive at an index value of >3.5, you are likely infected with HSV 2. But if negative, you would need to wait to retest until at least 6 weeks when the test would pick up about 70% of infection compared to one done at 12 weeks.

Terri
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26 months ago
The sore was never prominent enough to be swabbed ... it was a bit swollen the first night and then it just diminished in color to where it just looks like a random skin bump now. You saying it's uncommon makes me feel a bit better. Are swollen lymph nodes in the groin normal if it's hsv 1 that's already in my system?

Also, was there an HIV risk in this encounter? He was rubbing my penis against his anus for about 15-20 min. and said he was negative/on PrEP. I think I felt my penis head go in/out slightly at some points but not full penetration.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
I don't feel that there was an HIV risk there, no
You think your penis head might have gone in and out slightly?  You mean in and out of his anus?
Swollen lymph nodes in the groin could certainly be present due to reactivation of HSV 1 that you already have.  Were you swab tested from a lesion to determine that you were infected with HSV 1?

Terri
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26 months ago
Yes, in and out of his anus - just my head, not full shaft. Should I get tested for HIV just in case?

Yes, I was swab tested 5 years ago to determine it was hsv 1. This current lesion is too minor to be swabbed and looks like a tiny irritated skin bump that's now almost skin-colored. I also have a couple of rash-looking spots on my thighs. Do you still think it's unlikely it's type 2?

My co-worker just finished fighting the flu which I might have gotten and fought off, just felt fatigued for a day or two, and I did consume an abnormal amount of alcohol last week (lowered immune + triggers from holiday season?)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
It is unlikely that your rash was HSV 2, correct. 
If you would feel reassured by an HIV test, I see no downside to doing that. 
It is the season for flu like viruses (hope you got your flu shot) so the fatigue could certainly be due to that.  If you got HIV infection, I think there would be more symptoms than mild fatigue for a day or two.

Terri
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