[Question #5537] HSV resistance?
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74 months ago
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Is there evidence of resistant hsv? I have been on courses acyclovir, valacyclovir, and famciclovir without resolution of symptoms. After finishing treatment, I've also started on suppression therapy in between treatments. I have not tested positive for hsv via serology after having symptoms for 4 months now but the clinical presentation fits. The one exception is that the papular "rash" has been pinpoint "sores" that itch and are not painful on my pubic region. Not on my genitals at all.
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Terri Warren, RN, Nurse Practitioner
74 months ago
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So wait - how do you know that you have herpes? Did you have a positive swab test from a lesion? I'm a little confused. Herpes outbreaks don't last for four months and I would be surprised if none of the three medicines worked on a herpes outbreak. Do the lesions are in the pubic hair, not the genitals? Are they open sores? And again, who diagnosed you and how?
Thanks
Terri
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74 months ago
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I have not been diagnosed by lab confirmation. My physician has tested me twice which both were negative and I have not had open sores to test (last tested 2 months after initial sxs). We are treating based purely on clinical presentation and in case I haven't seroconverted. The sores are sporadic on my pubic region and I've also taken courses of antibiotics to rule out folliculitis but I've shown no improvement. How often do you hear/see atypical presentation of hsv? What tests do you recommend next to rule in/out hsv?
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Terri Warren, RN, Nurse Practitioner
74 months ago
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Your issues do not sound herpetic to me.
The best way to test is to do a western blot for herpes 3 months from the time of possible infection. However, if you have been taking antivirals for more than a couple of weeks, you should wait until you have been off antivirals for 3 months. The IgG test is OK but misses 8% of HSV 2 and 30% of HSV 1 infections.
I would also suggest that you see a dermatologist for an evaluation.
Terri
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