ghsv 1...

[uhohpain]

3 months ago I had what I think was a cold sore on my gums.

A few weeks later I had muscle fasciculations all over my legs and buttocks and a little in my penis. A few days later I had burning in the tip of my penis for a few days. (Continual burning) Slight white discoloration in the tip.

I also had nausea, back pain, and extreme thirst. Then I started getting nerve tingles (pins and needles)
all over my thighs and buttocks. Also had widespread genital irritation.

I tested positive for HSV 1 (IGG 2.0) and negative for HSV 2.

I never had pain, no blisters, no rash with this. No symptoms while urinating.

I haven't had any symptoms since (other than severe depression from all this). I have some body aches now and had a bit nausea, but not much else going on.

1)Does this sound like ghsv 1? Could this be something else?
2)What do I tell future partners? I'm 50% sure I have an std? haha
3)Is there any way for me to know for sure about the GHSV?

[Edward W Hook, MD]

In my experience patients with HSV infections do not develop neuropathy.  When persons think their neuropathy is due to HSV and have taken antiviral therapy, the antivirals have not helped.

If you think you have a neuropathy you should see a neurologist.  EWH

[uhohpain]

Thanks Dr. Hook. That helps me cope with this a little better. One last question... if the nerve tingles and muscle pains don't subside, should I look into anti-virals or go see a neurologist or both? Have the anti-virals helped any of your patients with the neuropathy?

[Edward W Hook, MD]

I see no reason to explain anything to your partners other than you may have cold sores (and I am not sure about that).

Supressive therapy is typically not recommended for persons who have HSV-1- the low transmission rates in the absence of lesions just do not warrant it.

If you really want to know if you have HSV-1, you should request a Western Blot test to be performed at the University of Washington.  Your doctor or his/her lab can draw the blood and have it sent.  I think the odds are at lest 50/50 that you do not have HSV-1.  EWH

[uhohpain]

I guess I'm confused on next steps... Is there no way to do a daily PCR swab for several months and see if there's no shedding?

I guess I just have to explain the situation to partners. I may never have a sore.

Is there a lower risk of transmission if I haven't had an outbreak? What medication would I take to reduce transmission risk for hsv 1?

[Edward W Hook, MD]

Welcome to the Forum.  I'll be pleased to make some comments.  My comments will be meant to agree with those you have already received from Terri but may be a bit more direct than what you have already heard.

I am not sure that the lesion you describe on your gums was a herpes lesion and doubt that any of the symptoms you describe are in any way related to HSV.  As Terri has already told you, nearly 60% of Americans have HSV-1 infection and of those less than 20% even have lesions (typically cold sores, in a minority of persons genital herpes).  Most people with herpes are unaware and without any symptoms at all.  On the other hand, we regularly see persons who, like you have had a positive antibody test and then begin to attribute or even experience a variety of symptoms.

Further, herpes antibody tests of the sort you have not uncommonly have falsely positive results due to cross reactions with antibodies to other viruses such as the virus that causes chicken pox.  

With respect to the lesion on your gums, this is not a typical location for a herpes lesion.  Herpes lesions/cold sores typically involve the border of the lips and the mucosa of the mouth.  

If the lesion was herpes, it is almost certain that your genial and buttocks symptoms are not due to HSV-HSV infections very, very rarely occur at two such separate locations.

As Terri has told you, the only way to really find out if you even have HSV is to have a PCR or culture test performed on a lesion, should a lesion recur.

I hope these comments help. EWH

[uhohpain]

I guess I should also mention there are red lines on both sides of the scrotum where the thigh meets the scrotum, but those have been there for a month+.