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I have both HSV1 and 2 in the genital

I am a female. Does having both HSV1 and 2 in the genital area makes you more at risk of transmitting it? I believe I'm asymptomatic since I only had two very small outbreaks a few months apart since my diagnosis in October. However, my concern is how often I am shedding and how contagious am I to my boyfriend who does not have herpes? We don't always use protection.

Also, I have been prescribed the generic brand of Valtrex.  But I don't want to use it daily because I'm afraid of the side effects. I started using Lysine daily.  Does Lysine really work?

Last- since I have been infected with herpes I have had chronic yeast infections. Are they somehow related?
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Avatar universal
Thank you again for your help!
Helpful - 0
1 Comments
I'm not sure what you're thanking me for - I didn't really figure anything out for you. :(

Let me know what you decide to do, and what your test results are, if you decide to test. I wish I could have helped more.

207091 tn?1337709493
COMMUNITY LEADER
Oh my god.  I'm confused, too.

So first, we can ignore the IgM. Let's take that out of the picture. It's a worthless test, it's wrong at least as often as it is right, but some estimates say it's wrong as often as 90% of the time. It's not type specific, so it's not helpful even if it was correct, which we don't know. So let's ignore that. Also, the IgM is looking for new infections. Your test was done in March. Your infection was in Sept. That's not new, medically speaking. The IgM antibodies wouldn't be there any longer. IgM antibodies may last a few months after infection. You tested at about 5.5 months, give or take. You wouldn't have IgM antibodies at that point.

So you have a positive culture that only tested for type 2 in Sept, because, as they explain, type 1 dual infection is extremely rare, so they skipped it. (eye roll - that's my editorial comment. It may be rare, but what if you were one of the rare ones? Unhelpful.)

Then you had negative type specific IgG hsv1 and hsv2 tests in March.

I would suggest that you get a Western Blot test done. The IgG hsv2 misses about 8% of infections, and the hsv1 IgG test misses about 30% of infections. The Western Blot is a different kind of test and looks for different things, so it doesn't miss the infections. If you have it, it will find it.

A culture is typically considered the gold standard, but there are errors, and human error, especially. Given that you have conflicting results, I'd recommend the WB.

You can have your doctor order it, if she will. If she won't, you can go through Terri Warren at Westover Heights but you'll have to self-pay. https://westoverheights.com/getting-a-herpes-western-blot/

Whatever you decide, it's right for you. It's okay. You can schedule a consult with Terri and get her opinion - she's the best there is. Whatever you decide, we'll be here to help you walk through it.

I'm sorry it's so confusing. :(
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Avatar universal
These are all my lab results. Now I'm really confused:

https://imgur.com/a/XX7Xv5L
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Avatar universal
I did confront him with this after I found out. But he's in denial ... it's sad because I'm sure he's infecting other people. And yes we had both oral sex and intercourse.  What you saw are the notes based on the swab test results. I do go back to my doctor tomorrow morning to check if I have BV. I'll request a copy of the blood test then. Thank you for your responses.
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207091 tn?1337709493
COMMUNITY LEADER
Okay, all that means is that your doctor is diagnosing you with type and type 2. Those are basically his clinical notes, not lab results. That doesn't show how he came to that diagnosis, and we know he's an idiot.

It would be really unique for one swab to come back with 2 types of herpes on it. Again - not impossible, but really unique.

I'm not disputing that you have herpes - if you had a positive swab, I'm sure you do.

Do you know your source partner? Did you tell him about all this? Has he been tested? Did he give you oral sex as well as you having intercourse?

If you do have both in the same location, we just don't have a lot of info on how that affects shedding and transmission. I can't find anything on it. :(
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Avatar universal
As for the positive-negative blood test I have to get those results from my doctor's office.  I don't understand what that means either. But I know for sure I have it because of the swab test.
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Avatar universal
https://imgur.com/a/I3r3Yut
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Avatar universal
I did end up going to Planned Parenthood and got a prescription.  And yes my doctor is an idiot. I struggle with getting accurate information. I was told that unless I have an active outbreak I'm not contiguous and not to worry. I'm reading otherwise.

I tried uploading my results but it did some weirdness that I request to have removed for privacy purposes.  I understand once you get a swab test it is 100% accurate.  So my question is having both HSV1 and 2 in the genital area, does this make me worse? as far as shedding and transmission.

And the discharge to your point can be BV and yeast. I'm going back to the doctors tomorrow.  But are both somehow associated with having genital herpes?  

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You can't upload images to a post, but you can upload it to imgur or another hosting site and post the link here. Just make sure your name or any other identifying image is not shown.

Yes, the culture is accurate for having herpes, but I'm wondering, especially now knowing that your doctor is an idiot, if he misinterpreted the results somehow and you only have hsv1 or hsv2 genitally. I'm not trying to get your hopes up, but I just want to be sure I'm giving you the correct information.

It's not uncommon to get yeast or BV as a secondary infection with your first outbreaks. My first 9 months, I had BV and didn't know it, and it was keeping my herpes really active. As soon as I figured that out, things really calmed down.

Even before figuring out if your diagnosis of hsv1 and hsv2 is accurate, having a secondary infection can trigger shedding. You might not be shedding higher levels of virus, but you could be shedding more often.

I missed this earlier - "I also recently got re-tested via blood and it came back both positive and negative." - what does that mean?

207091 tn?1337709493
COMMUNITY LEADER
How do you know you have both hsv1 and hsv2 in the genital area? How were you diagnosed with this? Did you have cultures that came back specifically with both hsv1 and hsv2?

If you had a culture that came back positive for herpes, and then had a blood test that says, "HSVI & II IgG positive", that is a combination test that means that you are either positive for type 1 OR type 2 OR both.

Can you get your lab results and post them here and we can figure that out?

It's not impossible for you to have both, but I just want to make sure you have been diagnosed correctly.

We don't have a lot of info about what having both genitally does to shedding rates. What side effects of Valtrex are you afraid of? It's safe to take long term in most people. Lysine may help prevent outbreaks but it doesn't do anything to help reduce shedding or transmission.

Have you tested positive for yeast? I ask this because you could be self-treating for yeast, but could in fact have bacterial vagnosis, which is also a very common vaginal infection. You could have both yeast and BV. If you are having chronic yeast, you should see your doctor.

Has your current boyfriend actually tested negative for herpes, or are you all going by symptoms?
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2 Comments
I had one small blister in my genital area didn’t know what it was. Went to my GYN and got a swab test. It came back positive for HSV1 and 2. I also recently got re-tested via blood and it came back both positive and negative. I didn’t understand that result and my doctor wasn’t great at explaining it. I was dating someone who had active outbreaks I had no idea what it was until I got diagnosed. He told me it was allergies (smh).

My new boyfriend was tested before meeting me. He did a blood test it came back negative.  We have been sexually active for only 1 month. I held out on having sex with him for 6 months out of the fear of giving him herpes. We were using protection and recently stop.

As for the yeast infections. They have been aggressive and worse in the past few months. I have gone to my doctor and got tested. They continue to prescribe my Diflucan. I was wondering if it could be some form of herpes shedding via vaginal discharge. I don’t have irritation or smell. It’s just really watery, a lot and white.

My doctor refused to prescribe me Valtrex because I haven’t had any major outbreaks. I assume it’s because of the side effects. I don’t want to introduce any drugs that have a long-term effect. But I’m also risking my partner …
I'd love for you to be able to get a copy of these results. Does your doctor have a patient portal or anything? Maybe you can call and get access to it so you don't have to go in if your area is locked down? You have the right to your lab results. If they ask why you want them, you don't have to explain, but you could say you are putting together your own medical file, or you are dating someone new and are going over STD histories or whatnot.

I can't explain the swab, but my guess is that either your blood test was a combination test.

If your doctor refuses to prescribe you Valtrex, find a new doctor. We've known since 2004 that it reduces transmission of hsv2 by at least half when it's taken daily. I don't know that it's because of the side effects, or your doctor is an idiot.

Is there a Planned Parenthood near you? They take insurance, and are usually great with all women's health issues.

Transmission rates for hsv2:

Ghsv2 transmission, female to male, over the course of a year, assuming sex 2-3 times a week:

Only avoiding sex during an outbreak - 4-5%

Adding condoms OR daily suppression - 2-3%

Adding condoms AND daily suppression - 1-2%

Call your doctor and see if you can get all your lab results, and see if you can't get seen at a Planned Parenthood to see if yeast is what you have. A white, watery discharge doesn't sound like yeast.
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