[Question #979] HSV 2

50 months ago
Hello.  I was recently diagnosed with HSV 2 by blood test 8.49. HSV 1 test came  negative at 0.06. Since my first outbreak in March, I have had a lot of symptoms of tingling and burning but no sores. When these symptoms start, I start taking Valtrax.  I can not go a week without symptoms so Dr. gave me rx for 500 mg daily.  I have read HSV 2 orally is rare, but I have had 3 outbreaks on my lips in the past month. My question is, is this normal, if statistics are saying HSV 2  infrequently reoccur on/in the mouth? I've had more outbreaks on my mouth than genitally.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
So Tamika, have you ever had a swab test of an oral lesion to determine that that is actually HSV 2 or just a blood test or just a genital swab test?  When you describe outbreaks o your lips, can you tell me more about what that is like exactly for you?

Terri
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50 months ago
Good morning Terri. 
In March I had lesion on my behind swabbed but it came back negative. Blood test came back positive. I've never had lesions on my lips swabbed, because soon as I feel tingling and burning I up my medication and the blisters go away. But the spot stays red and uncomfortable for a few days.

 I was beginning to be okay with the genital diagnoses till I started having same symptoms on my lips. :( They usually appear a day after I've been under a lot of stress. The medicine has kept me from getting to the sore stage but not orally.

 I am seeing a new Dr who said it can travel through the blood to a new spot . Which concerned me because I have yet to read that. She has also put me on Valtrax 1 g 3 times a day for 3 weeks. That high of a dosage concerns me also. The dosage was upped from 500mg daily, because my symptoms are constant.  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
It is incorrect that it can travel through blood to a new spot.  I would strongly disagree. 
The blood test misses 30% of HSV 1 infections, so one thing you might consider would be to stop the medication, get an actual oral lesion (not just tingling and burning) and swab the lesions and be certain that if it is positive, that it be typed (HSV 1 vs. HSV 2).  It is very likely that the lesion on your buttocks was herpes, but if your doctor is still using culture (vs. the newer and better PCR swab test) that it was falsely negative as the culture misses about 75% of infections compared to PCR.  So to be clear - you actually get sores on your lips vs just tingling and burning, right?

Terri
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50 months ago
Yes Terri I have had oral lesions on lips at least 3 times.  Since being diagnosed I have had oral symptoms along with genital symptoms but no lesions till June.  Its so concerning to me that I've been diagnosed for genital but having more oral outbreaks.
If not a hsv 1 infection have you ever heard of hsv2 reoccurring so frequently? Will the high dosage Dr prescribe calm the virus down? If not what dosage do you recommend for suppressive therapy since I was still have pronounced symptoms with 500 mg daily? I'm not sure when I can get oral lesion swabbed because the pain is so uncomfortable im not ready to stop the meds. 
I appreciate your time and I'm thankful to be able to talk to a professional healthcare  person. It's truly a blessing, when your going through such a rough patch in life.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
If the lesions are herpetic, the high dose may well calm them down.  That is the shingles dose so not unsafe. 
So have you had genital lesions swabbed to be diagnosed with genital herpes?  I am assuming yes. 
yes the number of oral outbreaks you are having is very high for HSV 2 which is why I thought you should have them swab tested because the blood test misses 30% of HSV 1 so they could be HSV 1 instead.

Terri
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