[Question #8101] I am worried about the possibility of getting genital herpes.

48 months ago

I am a Caucasian female 40 y.o. single, no children. I’m positive for HSV1 and negative for HSV2 (tested in 2019, 6 July 2021 and 16 July 2021). Results of 6 July 21 the numbers for HSV1 were crazy high >58, HSV <0.5 and IgM limit 0,9. results of 16 July 2021 I got HSV1 >8, HSV2 <0.5, IgM>3.5. why I did two tests for HSV2 at 07/2021. because I have a new boyfriend since 04/15/2021. we started unprotected sex after STD screening and the pill around 6 May 2021.HSV2 wasn’t tested. I presented a urinary tract infection in late April 2021 and both of us took treatment. Our relationship is at my knowledge exclusive. In late June 2021 and after intensive everyday sex I saw by chance a lesion in the base of his penis shaft. It was already scabbing. He never knew to be HSV2 positive and this lesion wasn’t painful nor itchy nor nothing. He didn’t even notice it;I told him it’s genital herpes. I took a photo and send it to firstderm.com and they said herpes. He did a blood test and he came positive for HSV2 with a number of 12,7 and negative for HSV1 with 0.3 and IgM < 0.8. his general doctor said the lesion is not herpetic but an irritation. first contradiction, between his general doctor and firstderm. He visited the dermato, about 7 days after I noticed the lesion which had begun to heal. The dermato told him its psoriasis. The dermatologist didn’t perform a swab test and didn’t give any treatment. I’m worried if my results will seroconvert and when. I don’t have any symptoms. i dont want to have it. i didnt have any penetrations since i saw the lesion.

Terri Warren, RN, Nurse Practitioner

48 months ago

Well, given that his index value was 12.7, he has HSV 2 and I suspect that the lesion WAS HSV 2. So many providers mistake herpes for irritation or friction burns or getting their penis caught in their zipper - any number of erroneous explanations for the breaks in the skin. Or psoriasis! he has HSV 2 genitally and now the issue is what to do about it and what about you.

In order to help you best, could you tell me the approximate date of your last intercourse? I'm thinking it is the June date that you mentioned but I would like to be more certain. If that is true, then your antibody test was done about two weeks later which is too soon to detect a new infection with any accuracy.

IF you acquired HSV 2 from him, your HSV 1 infection would likely keep a new HSV 2 infection mild or without symptoms. A repeat antibody test should be done at least 6 weeks after your last intercourse, which would then be 70% accurate - there is a 70% chance if you became infected that the test would pick it up.

Do you want to continue the relationship with this person? If yes, he should be using condoms with intercourse and to be most protected (not perfect) take daily antiviral medication.

Terri

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48 months ago

hello mrs Warren, thank you for answering me fast. I cant remember the exact date i had intercourse with him but i guess it was about end june 2021 - the last week i guess. What are the chances i got it? I m crying every day. I m very very sad.i m not having sex with him until i find out what is happening to my body. we were on vacation together last week , i didnt have penetration . Is fingering or receiving oral sex dangerous for transmitting? is going to the toilet and not washing his hands afterwards and then touching me dangerous?what about if i have a cut on my hand and he touches my hand? what about asymptomatic virus shedding? is touching my skin dangerous? I read that in couples that are discordant for HSV2 the infection is 5 -10% for transmission in the first year. is this true? Does that mean that i may have a chance not getting it? do i need to take now an attack dose of antiviral drug? how will i know if i have symptoms? should i do a blood test mi august? should i do a western blot test (although i dont know where in france or greece where i ll be for vacations) ? i dont know him well enough but i was happy to meet him and i didnt think that i would have to face that so i m completely lost about continuing the relationship or not. i wouldnt pose myself that question that early under other circumstances. i wanted to discover him more and get to know him.... i m really very sad for all of this. it feels very unfair .

Terri Warren, RN, Nurse Practitioner

48 months ago

If he has HSV 2, which I suspect he does, fingering and him giving you oral sex is not a risk of transmission for HSV 2 genital infection. Him using the toilet and then touching you is not a risk. It is not a risk of he touches your hand and you have a cut. Touching your skin is not dangerous. The transmission risk comes from his penis touching your genitals. No other way. Please reconsider taking an antiviral drug as doing so could make your testing inaccurate. Best not to.

If you live in Europe, getting the western blot will be challenging for sure. I would suggest that you start with a simple IgG test and do it in another couple of weeks.

HSV 2 is not always transmitted from an infected person to an uninfected one. You may well NOT be infected. Try not to jump to conclusions here.

The thing is, everyone brings something to a relationship that isn't ideal - this is what he brings, I'm sure you also bring something. If he uses condoms with every intercourse and takes daily antiviral medicine, transmission to you is very unlikely. You'll just have to decide if the risk is something you can live with.

Terri

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48 months ago

Hello i didnt take yet the blood test i m waiting as you told me. i ll be back in my country Sunday. So i still dont know if i became positive or not. i dont have any symptoms. I visited a dermatologist in the town i m now and she told me that i shouldnt break up for herpes if the relationship is good.i dont know if its good i know him 4 months. and he ruled out having kids because he already has and i dont. he is willing to take antiviral drugs only if he has lesions and not everyday and for the condom he will accept to use it for a while , the time i need to understand but then he doesnt want to use it. He is waiting for me and he will want sex Sunday upon arrival. Its been 2 months we didnt have sex because i freezed when i saw the lesion and on the phone he sounded tired with the whole thing. What should I do? i miss sex also and I need some reasoning please.

Terri Warren, RN, Nurse Practitioner

48 months ago

It sounds like there are significant issue with this relationship - he doesn't want more children, perhaps you do?

He is unwilling to take a very safe and effective medication that will reduce transmission to you by half. He will only use condoms for a while.

Are you willing to risk getting a life long condition for someone you aren't sure you want to be with and who isn't willing to do the easy things to prevent transmission?

It's your call of course. But think carefully about this.

Terri

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