[Question #9749] Hsv1/Hsv2 risk exposure

29 months ago

Hi Everyone,

Looking for some guidance regarding my situation. I recently made out, got a bare back blow job, and had condom vaginal intercourse with a women who tested positive for Hsv1 and Hsv2 both results around 7.5H. This happened on Monday March 13th around 5pm. To date(5 days post exposure) I have not had any visible painful sores appear on my lips nor my genitals and she did not have any active lessions that I noticed( did not look inside her vagina lol). I plan on getting IGM and IGG tested on the 17th. I'm more worried about getting HSV1 on my genitals and HSV2 on my genitals. What % of people do not have initial hsv2 initial outbreaks? Do all exposures usually transmit the virus? I know igm test are not very reliable do you recommend any other reliable test with shorter window periods that I can do since money is not a cause of concern at the moment. Thank you for the help in advance and I really appreciate each and every response. I am also on PEP(Truvada/Trivicay),which i heard can decrease Hsv2? Any guidance would be really apprecaited

Terri Warren, RN, Nurse Practitioner

29 months ago

Do not bother with the IgM testing - the CDC says never to use it as it has many false positives and does not help to sort out new vs old infections.

If you want to test, and I would caution you about the risk of false positives with the IgG test, you should wait at least 6-8 weeks where you will get about 70-80% sensitivity on the test. The condom will reduce the risk of HSV 2 infection by about 65%. I'm not clear on the amount of reduction of HSV 2 transmission with PEP.

I've you've not had any symptoms yet, that's a good thing. The average time from infection to symptoms is 5.5 days. if you get any, be certain to go in and be swab tested.

If you've ever in your life had a cold sore on your lip or in your nose, then you already have HSV 1 infection and are extremely unlikely to get it in a new location on your body

Terri

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29 months ago

Hi Terri,

I appreciate your response! I've never had a cold sore and went through a std panel a month ago with everything coming back negative. Still no symptoms, which seems promising. Some follow up questions I have are: Is it normal to be asymptomatic for HSV1/2 in the initial outbreak? Is it common one exposure will cause HSV1/HSV2? I saw their is a PCR test available with blood/serum, will that decrease the testing period? She was not showing any visible outbreaks that I could see on her lips/ around her vagina(not sure about inside since I did not look), but im guessing it would also hurt her to if she had any outbreaks. What are the odds of getting HSV1/HSV2 through just "normal" shedding?

Thanks

Terri Warren, RN, Nurse Practitioner

29 months ago

One exposure would almost never cause both HSV 1 and 2. And you should never do PCR blood test. Herpes isn't in the blood, it is in nerves and skin.

I don't know if you are saying that you tested positive for HSV 2 and HSV 1 or not?

The IgG test has many false positives. If you want the most accurate herpes test, consider the herpes western blot instead.

Terri

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