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STDs (Expert Forum)
Potential confusion around herpes info from GP
Answered by
University of Washington
Seattle - WA
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This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Potential confusion around herpes info from GP
by helppls25, Jun 18, 2008 11:59AM
DR HHH-
I would appreciate your POV on my situation as I just returned from my GP and am slightly confused-
Key Facts
*2.5 weeks into a relationship was informed by the person that I was dating that she has HSV2 (no interaction since then)
*Performed oral (both ways) 5-7 times during the 2.5 wks, no vaginal intercourse, however, grinding did occur around the penis/vagina
*The woman was diganosed with HSV2 15 years ago, no outbreaks during the past 10 years as well as no transmission to other men she previously dated
GP said the risk was very low, <1% (pls confirm). Went ahead and ordered bloodwork, however, all the interactions have occurred over the past 2.5 weeks, will this test be at all useful? The test is being performed by Quest Labs and the GP indicated there are no false positives with this test (different that what I read on your site). I will get a read on whether this potentially could be HSV1 and/or HSV2. He also indicated that past HSV1 (which I know 60% of adults have due to childhood) wouldn't show up. True? I want to get a clean read on HSV1 and HSV2, I had herpes in my eye as a child, would that appear and does it make me more likely to be prone to HSV1 or HSV2. I realize that I might need to take another round of bloodwork, if you agree, when would you advise in terms of how long I wait?
Final question, at this point, no symptoms What percentage of the people have symptoms/initial outbreak in the first 3 weeks? Said another way, how rare is it if I don't have any symptoms in the next couple of weeks that I might have HSV1 or HSV2?
Thanks
I would appreciate your POV on my situation as I just returned from my GP and am slightly confused-
Key Facts
*2.5 weeks into a relationship was informed by the person that I was dating that she has HSV2 (no interaction since then)
*Performed oral (both ways) 5-7 times during the 2.5 wks, no vaginal intercourse, however, grinding did occur around the penis/vagina
*The woman was diganosed with HSV2 15 years ago, no outbreaks during the past 10 years as well as no transmission to other men she previously dated
GP said the risk was very low, <1% (pls confirm). Went ahead and ordered bloodwork, however, all the interactions have occurred over the past 2.5 weeks, will this test be at all useful? The test is being performed by Quest Labs and the GP indicated there are no false positives with this test (different that what I read on your site). I will get a read on whether this potentially could be HSV1 and/or HSV2. He also indicated that past HSV1 (which I know 60% of adults have due to childhood) wouldn't show up. True? I want to get a clean read on HSV1 and HSV2, I had herpes in my eye as a child, would that appear and does it make me more likely to be prone to HSV1 or HSV2. I realize that I might need to take another round of bloodwork, if you agree, when would you advise in terms of how long I wait?
Final question, at this point, no symptoms What percentage of the people have symptoms/initial outbreak in the first 3 weeks? Said another way, how rare is it if I don't have any symptoms in the next couple of weeks that I might have HSV1 or HSV2?
Thanks
Doctor's Answer
by H. Hunter Handsfield, M.D., Jun 18, 2008 03:24PM
, Jun 18, 2008 03:24PM
It is rare for people to carry HSV-2 in or around their mouths. Therefore, oral sex almost never transmits HSV-2. In my 30+ years in a busy STD clinic, I have never seen or heard of a case of genital HSV-2 acquired from oral sex. Genital contact without penetration ("grinding") probably carries some small risk, but low compared to penetration.
Since you did not have genital sex with your new partner, there was no signficant risk of HSV-2 transmission. Even with genital sex, the risk of transmission from any single episode of vaginal or anal sex with an HSV-2 infected partner probably is less than one in several hundred exposures -- and it tends to be lower the longer the infected person has had HSV-2. So even if you had had unprotected genital sex, the chance you would have been infected was very low.
Thus, your GP was correct about your low risk -- virtually zero risk, in fact. To the specific questions:
1) I would not have recommended testing at all. But if done, 2.5 weeks is too soon for antibodies to show up.
2) False positive HSV-2 blood tests are possible. See the thread immediately before this one.
3) Your GP is mistaken about HSV-1 testing. Half of all adults in the US are infected and have positive blood tests, regardless of symptoms of oral herpes.
4) If you had past HSV-1 of your eye (or elsewhere on your body), your HSV-1 blood test should be positive. There are conflicting data on whether having HSV-1 reduces the chance of HSV-2 in people exposed to that virus. But you probalby weren't exposed to HSV-2 anyway, so probabaly not relevant to your situation. And if exposed to HSV-1, you probably wouldn't catch it; people generally are immune to new HSV infection with the same virus type.
5) Most HSV infections cause no symptoms or only mild ones that are easily ignored or forgotten. But most people who are on the lookout for symptoms probably would notice them if they caught a new HSV infection.
Bottom line: You weren't at risk for HSV-1 at all (if indeed you had it before), and your risk for HSV-2 was zero. You really have no worries about herpes.
Best wishes-- HHH, MD
Since you did not have genital sex with your new partner, there was no signficant risk of HSV-2 transmission. Even with genital sex, the risk of transmission from any single episode of vaginal or anal sex with an HSV-2 infected partner probably is less than one in several hundred exposures -- and it tends to be lower the longer the infected person has had HSV-2. So even if you had had unprotected genital sex, the chance you would have been infected was very low.
Thus, your GP was correct about your low risk -- virtually zero risk, in fact. To the specific questions:
1) I would not have recommended testing at all. But if done, 2.5 weeks is too soon for antibodies to show up.
2) False positive HSV-2 blood tests are possible. See the thread immediately before this one.
3) Your GP is mistaken about HSV-1 testing. Half of all adults in the US are infected and have positive blood tests, regardless of symptoms of oral herpes.
4) If you had past HSV-1 of your eye (or elsewhere on your body), your HSV-1 blood test should be positive. There are conflicting data on whether having HSV-1 reduces the chance of HSV-2 in people exposed to that virus. But you probalby weren't exposed to HSV-2 anyway, so probabaly not relevant to your situation. And if exposed to HSV-1, you probably wouldn't catch it; people generally are immune to new HSV infection with the same virus type.
5) Most HSV infections cause no symptoms or only mild ones that are easily ignored or forgotten. But most people who are on the lookout for symptoms probably would notice them if they caught a new HSV infection.
Bottom line: You weren't at risk for HSV-1 at all (if indeed you had it before), and your risk for HSV-2 was zero. You really have no worries about herpes.
Best wishes-- HHH, MD
One additional update/?, the woman I was dating went and had some bloodwork done, she actually has HSV-1, not HSV-2 (previously indicated), however, manifested in her genital area vs. mouth/lips when she had her last outbreak 10 years ago. Does this change any of your thinking in terms of risk for me? Since I had HSV-1 as a child, is it impossible for me to get/re-activate or somehow manifest itself in the genital area?
Thanks
Brad
The additional information does not change my opinion or advice. If you indeed had HSV-1 as a child, you will never get it in the genital area. The virus does not travel through the body to reativate at sites other than the initial site of inection; and people are immune (or at least highly resistant) to getting second infections with the same virus type.
You came to the forum for reassurance that you weren't likely to be infected with herpes. I gave that reassurance. Please accept it and stop trying to talk me (and yourself) into believing you were infected. Time to forget this entire business and move on.
I won't have any further comments.