[Question #7302] Herpes transmission

7 months ago
My question concerns herpes transmission. I recently had a brief affair with a woman who told me she has genital herpes. She said she had been diagnosed years ago and hasn’t had a breakout in years, she is also on daily suppressive therapy, acyclovir. We only had sex one time and it was unprotected. This was August 1. In the time since then especially 10 days after I was hyper vigilant and anxious about inspecting my genitals. I never developed lesions, no fever, no itching.But I did notice pink discoloration around my urethra, I felt some discomfort there as well but I was checking and pulling apart area frequently. The discoloration is still there.It’s very mild and hardly noticeable. But there again I am anxious. What are your thoughts? I haven’t had sex with my wife since the encounter
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
My thoughts are that it is highly unlikely that you acquired HSV 2 from this new partner.  First, the duration of her infection suggeststhat she is shedding virus infrequently.  Then add in the daily antiviral medicine and that reduces the risk even more.  Then add in that this was a single encounter and you've develped no sores in the genital area.  Urethra discoloration may well have been there for a while, but until you started checking often, you may not have noticed it.  Also, that is not really a sign of herpes.  Also, skin changes caused by herpes do not go on and on.  They come and they leave.  Nothing you have described here suggests that you acquired herpes at this encounter.

Terri
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6 months ago
Thank you ma’am, so without lesions I’m pretty much homefree? I was just concerned cause I read you can have it and never develop lesions? Also I read the blood test produces a lot of false positives.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
I don't even say someone definitely doesn't have herpes until they get the best test available, but I think it is unlikely in you.  The blood antibody test, the IgG test, has some false positive, but in seven years of doing the test in my office, and analyzing all the results, about 3% of people who test, obtain a false positive result.  But we are able to sort most of those out by doing the confirmatory western blot.  A bigger problem is the false negative rate, compared to western blot which is 8%.  About 80% of those infected with HSV 2 are unaware of their infection.  But I still think your situation was really low risk.  When interpretting results, we must always consider the concerning event and how high or low risk that event was.

Terri
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6 months ago
Ma’am last question I got the hsv-1 and hsv-2 IgG blood test my hsv-2 was negative index 0.23, my hsv-1 was positive index 32.20. Does the higher index for Hsv-1 mean I’m actively fighting an infection? Could I have hsv-1 in my genitals and not know it? I’m so confused 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
The HSV result simply means that you have a well-established infection and a robust immune response.  If you have received oral sex in your lifetime, then it is possible that your HSV 1 is a genital infection and that you don't know.  The only way to know if an HSV 1 infection is oral vs. genital is to have a lesion and then have it swab tested for herpes.

Terri
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