[Question #5261] Genital hsv1 and hsv2

23 months ago
Hello,

I was diagnosed via swab a year and a half ago with genital HSV1. I got my initial ob, which fortunately did not hurt. I got a second OB after getting a tattoo 3 months after my first OB. I got the leg feeling. 

I am now finishing my 3rd OB a year after my last. It is in the exact same location with the exact same sore formation as last time (two sores at the top and one at the bottom in a triangle formation). The sores again did not hurt and the OB scabbed over in a few days with valtrex. This time it burned before the OB which was my initial sign. Otherwise it was similar. I went for a swab but it was too early to detect and came back negative. 

I am nervous about it being type 2 because of recurrences and the different initial signs. 

What are the chances of contracting type 2 if I already have type 1 genitally? Since the outbreaks were so similar, should I assume it was a type 1 recurrence?

Thank you,
Kendall 
23 months ago
To add, I am concerned since a condom broke twice 2 weeks before with a man who has slept around a lot. He said he doesn’t have hsv2 since he’s never had symptoms and I saw no sores. But I’m still nervous. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
23 months ago
So condom breakage is a concern with any situation but there is no reason in particular to think that you have HSV 2.  If you are worried about this, you can always get an HSV 2 IgG antibody test to be more clear.  It is true that if you have HSV 1 genitally, it may be less likely for you both to acquire HSV 2 genitally subsequently but also not to have many symptoms if you acquire HSV 2 genitally after having type 1 genitally.  Have you had any particular symptoms that make you worry you might have HSV 2 or is it just that the condom broke that you are worried?

Terri
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23 months ago
I think the fact that this outbreak happened 12 days after it happened after a year of no outbreaks is what concerns me. But I also was very tired before I went out with friends the night before the outbreak happened and ended up getting only 2 hours of sleep. 

I have never had a blood test before for this and my doctor said she doesn’t recommend it since I could have had hsv2 as a cold sore before and not known it. She wants me to wait to see if I get another OB and swab test it again. I’m just concerned that It could be another year and I won’t know. 

I can confirm I’m not pregnant and all other std tests came back negative. 

If it was type 2, would it show up any differently? The sores are in the EXACT same formation and location and they were not painful like before. The only difference was the burning, but I’ve heard people can have different signs sometimes. 

I feel like it’s a really crappy coincidence that is giving me crippling anxiety. 

How rare is it to have both types in the same location?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
23 months ago
HSV 2 is very uncommonly oral in the form of a cold sore.  I disagree with her. 
I see no reason why this would now be HSV 2 and would recommend that you obtain and IgG test 12 weeks after the condom breaking episode, even if you have to order that yourself online.  I'm guessing this was a recurrence of your HSV 1 genital infection but it's clearly worrying you so get the test and I hope, get reassured.

Terri
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23 months ago
Are symptoms ever different? This one felt a little different (the burning sensation), but otherwise looked the same/didn’t hurt much after that. 

If it was type 2 would it be a little different? The only difference was the burning. Like different place or something? The sores were literally in the exact same spot and formation. 

Also, the scabs are gone and have been for a week, but there’s still redness where the scabs were. Is that normal? Does that mean it didn’t fully heal yet?

I think I need to calm down and just assume it is the type I already have since the guy said he didn’t have it and I’m just panicking over the slight possibility he could have it and I got it from having sex twice. 


Sorry for all the questions. My gyno isn’t easily reached via phone and I don’t want to keep googling. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
23 months ago
No, the symptoms are not different.
Red skin can be present with no virus present.
I also agree that it would be good to assume for now that this is just a reactivitation of your HSV 1.


terri
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