HSV Transmission without symptoms and Herpetic Folliculitis

[ConfusedCorey]

I have never engaged in genital to genital contact nor had sexual intercourse. Recently, I received unprotected oral sex from my girlfriend; she was a bit rough and there was no finish. I didn't clean off for a while and gave her unprotected oral sex for several minutes. The next day I noticed several lesions on my penis, which then got progressively worse over the next few days. I got tested and my doctor told me I tested positive for herpes, although she couldn't tell if it was HSV1 or 2. My girlfriend said she doesn't/didn't get cold sores and has been tested in the past with all negative results. Her results showed she tested positive for HSV1 so I'm thinking it's very likely I contracted HSV1 genitally from oral sex (possibly without her showing any symptoms). I also got Herpetic Folliculitis around my pubic area, hip flexors, and below my navel, which got progressively worse for a few days and didn't seem to be getting better. I was prescribed Valacyclovir but the doctor said it may have been too late in the breakout to really have an effect on it.

How long should I wait to engage in sexual activity with my girlfriend after a breakout? All the sores are healed and the scabbing is gone, but the area is still sensitive and I can still see the red spots where the sores were, with little red dots in the center of the old sores.

Since she is already HSV1 positive, can I cause her to have breakouts orally since she doesn't seem to have them now? If she is exposed to a breakout, can that cause oral breakouts?

I'm assuming I can still transmit it to her genitally since she currently does not have genital herpes, HSV1 or 2. Is this right?

Should I not engage in sexual activity with her if herpetic folliculitis is present? / Can I pass it to her? I understand herpes is viral and folliculitis is bacterial, but I am not sure about the transmission of it.

Any recommended treatment of folliculitis? Everything I've read and been told from my doctor is to just keep it clean, which I am very particular about already and it doesn't seem to be easing up. I've had trouble with lingering skin conditions in the past (acne, eczema, ringworm).

Also, I've read some interesting studies that allude to herpes being transmitted via semen. Does anyone know the likelihood of this?

[ConfusedCorey]

Hello again,

I called my doctor for the specific tests and results but they said I had to come in for them to get them. I went in yesterday and they are as follows:

HSV 1 IgG, Type Specific: 0.91
HSV 2 IgG, Type Specific: 0.91

HSV, IgM 1/2 Combination: 5.03

HSV Culture without Typing: Positive

When I brought up the above article and that it I sounded like Herpetic Foliculitis seemed doubtful, she basically responded saying it was probably herpes zoster and that it's treated the same way and that I most likely had a flare up because I was so stressed out but that it's unlikely to continue or flare up again. Thoughts or feedback on this? I don't really know what it means and she didn't seem concerned about it at all. Recomended treatment of it if it is herpes zoster?

Also, maybe a stupid question since you said it hasn't been shown to be transmitted via blood so does that mean I can continue to donate blood?

Thanks again for the help!

[ConfusedCorey]

Wow, thank you both for your responses and information, it truly means a lot.

I had a swab test and a blood test done, although I have to admit the whole process has been a mess and very stressful. I don't know many specifics from the tests and the results, but am trying to get more information from my doctor. I believe the tests were for IgG and IgM.

Originally, she did a swab/culture test on the lesions and drew blood. When they initially read me my results, they said everything came back negative then called me back 30 minutes later to tell me that the herpes culture had actually come back positive (they were still waiting on the blood work). I called back, frustrated, to figure out what the heck was going on and also informed my doctor that I had symptoms that were uncharacteristic of herpes. She had me come back in to take a look and re-swab. When I got there, she informed me that apparently the lab they work with is notoriously difficult to work with and they had messed something up with the blood work so she needed to re-draw and re-send for testing. She said the original culture was positive and that the other symptoms I was seeing looked more like folliculitis. I had several pimple-looking, white head-like sores near my hip flexors, above my pubic hair towards my navel, several in my pubic hair above my penis, one near the bottom of my right buttock/top of right hamstring and then one on my right quad. They were quite itchy, red, and painful. They also looked like they were filled with a sort of puss and definitely looked different from the blister-like symptoms I was seeing on my penis shaft, the foreskin and one on the head of my penis.

A week later she called to tell me the second swab had come back negative, which was expected as a result of the lesions scabbing over at that point but that the blood work came back positive. She said she didn't know if it was HSV1 or 2 and would let me know if she could find out. Some of the sores she thought were folliculitis started to heal, while others persisted and just in the past few days seem to have started going away. They, unlike the sores on my penis, are leaving a more scar-like or post-pimple-like dark red spot behind. Some of them seem to flare back up on occasion so I'm being very careful to keep them clean.

I will call my doctor again in the morning to find out specifics on the tests and post when I receive a response. Also, I'll ask her about the folliculitis.

Thanks again, it feels very relieving to have the support of a community like this.

[catinbarefeet]

We need a bit more information. What tests were used to diagnose you? It appears you got a swab, and it's unfortunate that it was not typed, as this would have been extremely important to determine. Did you also have a blood test, and if so, which one?

How was your girlfriend tested? Without a lesion, I assume she had an IgG.

Yes, from your evidence, it appears you contracted HSV-1 from the oral sex. She was likely shedding virus asymptomatically. About 1/3 of new genital infections are caused by HSV-1, usually acquired from receiving oral sex.

If she tested positive for HSV-1 via IgG, she has seroconverted, and is unlikely to re-contract HSV-1 anywhere on her body. She will probably not get genital HSV-1 if she does not already have it. She could have future cold sores, but not because of your HSV status. Something in her system or routine would trigger the recurrence - stress, diet, hormonal changes, etc. If she presents with herpetic folliculitis, it will be caused by her own HSV-1, not yours.

Incidentally, herpetic folliculitis is often misdiagnosed as caused by HSV. It's more often caused by varicella zoster - the chickenpox/shingles virus - and is quite rare. How do you know you have it? Here is an article from the NIH archives about it:

http://www.ncbi.nlm.nih.gov/pubmed/16536821

According to Anna Wald at the University of Washington, there are currently no documented cases that HSV is transmitted via any bodily fluids, including semen. The one "positive" report is thought of as likely to have been due to contamination.

I hope some of this helps!

[Fleetwood20]

In order to answer you properly, exactly what test did you have that confirmed the presence of HSV. Was it a blood test or a swab culture test?