[Question #9833] Herpes - HSV2

Avatar photo
28 months ago
My treatment for OCD is having ups and downs, when I travel for work I seem to have the hardest time, I feel a ton of guilt from sleeping with FSWs in the past and sometimes my demons from this get the better of me.  I have a simple question about Herpes.  I can never remember having an outbreak of genital herpes - no classic rash or anything that resembled it - no partner I ever had ever contacted me about anything.  I have two quick questions: (1) could it be possible for Herpes to stay in the body for 15-20 years and never have an outbreak? (2) could I still at some point or someone I slept with after this to have an outbreak this many years from my risk factors or is this very unlikely (3) Or is most likely that I never contracted herpes as I have never been tested bc I never had symptoms so I never felt the need to do it - none of my partners or my wife ever had symptoms - so is it most likely I never had them?  Thanks for all you do - you have helped me an incredible amount over the years.
Avatar photo
Terri Warren, RN, Nurse Practitioner
28 months ago
It is possible that you could have herpes for years and not know it but that is clearly the exception to how genital HSV 2 infection behaves.  The average number of outbreaks a person with HSV 2 might have in a year is 2-4, with more in the beginning and less as times goes on.  You aren't reporting anything like that.
The exception might be genital HSV 1 infection which rarely recurs and is rarely shed from the genital tissues.    However, if you have ever in your life had a cold sore on your lip or in your nose, then you already have HSV 1 facially (about half the population has HSV 1 infection) and would be highly unlikely to get it at a new location.  Most people who have HSV 1 genitally acquire it through receiving oral sex.  
If you had either and had not had an outbreak ever, it would be unlikely to suddenly start having outbreaks but it is possible.  
Have most of your contacts with sex workers been condom protected?  Condoms do reduce transmission of HSV during intercourse and if you've been using them, that is in you favor, for sure.  
The problem with testing is that the usual tests have many false positives and using them for screening for herpes is no longer recommended for that reason. 
If you do decide that you really want to know, then the herpes western blot is the reliable antibody test to detect infection.  
Please let me know if you have further questions.

Terri Warren
---
Avatar photo
28 months ago
Thanks for answering my question I really appreciate it - I used condoms 100% of the time for vaginal, 75%-80% f the time for oral. Three quick follow ups: (1) Since I have never had any outbreaks and since my partners never had any - do you think its highly unlikely that I would have a primary outbreak now, or any of my past partners could have a primary outbreak now after 10-20 years?  (2) Is there a very high probability I never had Herpes and this is just my OCD and guilt causing me to worry unnecessarily?  (3) When you state that herpes remaining dormant for years with no outbreaks is the exception - is exception like less than 1%, less than 5% - anything to quantify that even if its is a guess - I am mathematician and I think in those terms.  I am so thankful for what you do, all of you have helped me so much with my OCD and the guilt from mistakes made earlier in my life - thank you so much for what you do.

Avatar photo
28 months ago
I don't think I ever had a cold sore, but maybe I have - certainly not anything in recent memory - just to add to the information - again thank you so much for answering my question - after my other questions below, I will let you get on with your day - also I would like to make a donation to ASHA to help support the work that you do - where should I send a check - to the NC address - and should I just make the check out to ASHA?  Thanks again

Avatar photo
Terri Warren, RN, Nurse Practitioner
28 months ago
(1) Since I have never had any outbreaks and since my partners never had any - do you think its highly unlikely that I would have a primary outbreak now, or any of my past partners could have a primary outbreak now after 10-20 years?  
So if you had been infected previously with no symptoms or a partner was infected by you with no symptoms, and someone had an outbreak in the future, it would be a recurrence, not a primary outbreak.  It would be more accurately described as a first recognized outbreak.  And I do think it is quite unlikely that someone would have a first outbreak way down the road.

(2) Is there a very high probability I never had Herpes and this is just my OCD and guilt causing me to worry unnecessarily?  
I do think it is a high probability, yes.  

(3) When you state that herpes remaining dormant for years with no outbreaks is the exception - is exception like less than 1%, less than 5% - anything to quantify that even if its is a guess - I am mathematician and I think in those terms.  
I'm afraid I don't have that answer, quite honestly.
If you have this worry, and you can't put it away, I would suggest that you get a herpes western blot to know for sure.  If it was positive for HSV 1, it could not tell you where you infection is, however.  It could be either oral or genital.  If positive for HSV 2, it would be genital.  But I think you need to ask yourself, what would you do with these results before you ever test.  

I am so thankful for what you do, all of you have helped me so much with my OCD and the guilt from mistakes made earlier in my life - thank you so much for what you do.
I'm glad we can be of help.  We've all made mistakes in our past - I certainly have, anyway.  

Terri
---
Avatar photo
Terri Warren, RN, Nurse Practitioner
28 months ago
You are most welcome to send a check in support of ASHA.  It's an amazing group with a long history of dealing with sexual health issues.  Financial support would be greatly appreciated.
And if other questions pop up for you, reach out.  That's what we're here for.

Terri
---
---