I have herpes but my doctor is unsure if its HSV-1 or HSV-2

She doesn't know if its in the gentials or the mouth region

I believe its in the gentials tho, but I never been with a man I am a lesbian I haven't had ORAL sex in a year

I been with 1 female since last nov. she doesn't give me oral.. we do bump vagnas though grind and rub

shes been with men and women both but she hasn't told me shes sick

she said shes sick cause of her period and thyroids

we still been having sex everything I do something with her I get real sick I break out on the back of my arms and down below I don't have meds because my doc said my test where negative for 1 and 2

but I had been exposed with a 1.55 index

Hi PHM,

First of all, *deep breaths* and <>!! I know how hard it is to not know what exactly is going on with your body. Know that you are definitely not alone in this, and that once you find out for certain why you are having these symptoms it will feel like at least some weight is lifted. Hang in there!

Do you know what kind of lab test your physician did to tell you that it's HSV? Both the culture swab (where your doctor would have taken a sample of fluid from your sores on a sterile cotton rod, and the test would show whether a virus's DNA is present) and the blood test (where your doctor would have sent you to the lab for a blood draw, and the test would look for antibodies you produce in response to the virus) would be able to distinguish between HSV-1 and HSV-2.

If you haven't actually been tested with either of these methods, schedule another appointment or see a different clinician.

I'm not a licensed medical professional and this is a forum and not a clinic, but I can at least give you some starting questions to bring to your doctor the next time you do go in for a visit.

1) What kind of test am I getting? How accurate is it?

2) I want to see if antivirals could be effective against what I'm experiencing. Can you tell me about medications I can try when I'm having symptoms? (Acyclovir =Zovirax; Famciclovir = Famvir; Valacyclovir = Valtrex).

3) What is the most serious thing you think this could be? (Or better, what is on your differential diagnosis?)

If your doctor has already given you blood test results, and he/she is convinced you do not have HSV-1 or HSV-2:

4) Is it possible I could have shingles (herpes zoster)? What are the tests and treatments for this?

Note: shingles is not sexually transmitted, and is basically an adult recurrence of chickenpox with generally more painful symptoms. I'm not saying this is what you have, but it might help to keep it in mind as a possibility.

Some questions about your symptoms for YOU to think about (you definitely don't have to share the responses here unless you want to, these are to guide your preparation for your doctor's visit because you will probably be asked these and other questions):

1) What are your most troubling symptoms? Are there any symptoms that seem to go along with the primary ones in terms of time or location?

2) When do they occur? How frequently do they occur?

3) Do you have pain when you urinate? Do you have fever? Headaches? Nausea or vomiting?

4) Are you in any pain? If so, how would you describe the pain? Rate it on a scale of 1-10.

5) Have you ever had chickenpox as a child?

6) About the breakouts on the backs of your arms: does it look like there is a clear line dividing the sores and the normal skin? (Kind of like this: http://www.skinsight.com/info/files/image_upload/dermatomal_vesicle150%20copy.jpg)

7) Does anything make your symptoms better? Does anything make them worse?

I hope this helps. Best of luck to you in finding out what this is, and we are all here for you now and after you get a clear diagnosis, whatever the cause may be.

dr_h_positive:

I think we are going to LOVE having you here. It will be good to have someone who can read the medical jargon and make it understandable for the folks on here...and who knows the questions to ask.

And I'm curious to know what that image was... I'm a Massage Therapist so anything like that is good info for me to know :)

Yes my doctor did a bleed test, but it came back negative for hsv 1 and 2

but my hsv index was 1.55 so my doctor said I've been exposed

to the antibodies I just don't understand

now I feel like my mouth itch my buttocks burns everything

its crazy but I am going to my obgyn soon

I did have chickenpox as a child, and the woman that I've been sleeping with

I don't believe she is sick.. then again who knows people don't have symptoms

but I will ask my doctor the questions you mentioned to me

WCSDancer2010,

Thanks so much for welcoming me! I've read a lot of what you've posted too, and think you are just wonderful. I have an exam tomorrow but will probably work on a longer post afterwards to translate in general terms some of the more technical things I've been reading and think might be interesting to everyone. I'm a strong believer that knowledge is freeing and am happy that I may be able to contribute to the conversation in a meaningful way.

I included that image because PlzHelpMe mentioned breaking out on the back of her arms, and it sounds like from this and previous posts that there may be some ambiguity in whether this is HSV at all. The image is of shingles, also known as herpes zoster.

There are five species of Herpesviridae (the family name of highly related DNA viruses) that are considered common in humans: HSV-1 (orolabial herpies), HSV-2 (genital herpes), varicella zoster virus (chickenpox and shingles/Herpes Zoster), Epstein-Barr virus (which causes mononucleosis, aka Mono), and cytomegalovirus (primarily affects salivary glands, is extremely dangerous to immunocompromised people, and has a prevalence of about 40% worldwide).

What all viruses in this family have in common is that they have the ability to remain latent in the body by persisting in specific structures, and then recur later on as an active form when the virus again undergoes rapid levels of replication using the host's cellular machinery (as well as shed periodically or constantly at a subclinical level - this means without symptoms). The word "herpes" comes from the Greek "herpein", which means "to creep" and refers to the ability of the virus to live silently in the body during dormant stages of its life cycle.

From here, HSV and VZV/chickenbox/shingles have something further in common: these 3 viruses have evolved to inhabit the nervous system (specifically the spinal cord and, in the case of HSV-1, the trigeminal ganglion...but I can get into all that later and with pictures O_o). Let's just focus on HSV-2, genital HSV-1, and VZV for the purposes of this discussion. HSV infection happens when the virus makes a skin-to-skin jump (assisted by mucosal membranes, aka the slippery parts, or by microlesions in the skin). From there, it targets tiny cutaneous nerves that bring sensation (touch, heat, pain, etc) from the surface of the skin back to your spinal cord so that your body can know what you are feeling or if you are hurt. Because those signals travel back towards your spinal cord, you can imagine how a virus infecting one of these neurons (aka nerve cells, which can be really long) might make it all the way back to the sensory ganglia near your spinal cord (these are called dorsal root ganglia and they are structures at each spinal cord level). There, they connect to neurons in the spinal cord itself, and those cells then conduct signals to higher order structures (aka so your brain can tell you to move away from heat). Herpes viruses, however, typically stay at the level of the spinal cord that sends out the sensory nerve supplying the part of the skin that was first infected. That is why recurrences usually happen at exactly the same spot, but with less severity, where the primary infection was. The virus will remain, dormant and therefore less responsive to acyclovir class drugs (which can only act to halt actively replicating viral DNA), until something triggers it to start dividing again. When this happens, the infection travels retrograde back down the sensory nerve (starting from near the spinal cord to the near the skin), where it makes contact with and irritates tissues and cells of the skin.

Phew! Still with me? Again, I'm hoping to make a post using better language, analogies, and illustrations later on. There's one last part to this very long answer to your question. Herpes zoster (aka varicella aka chickenpox aka adult shingles) is very similar to the HSV pair of viruses. Instead of being sexually transmitted, most people contract their primary infection as kids from other children, and the symptoms, while itchy and annoying, are very temporary and not that severe. This usually immunizes people against further acute reactions later on in life, although the virus remains in the nervous system forever and is dormant. The reason for this immunizing effect is that the chickenpox episode causes the body to create antibodies (immune cells) to specifically fight against the virus, just like a vaccine would. The bad news is that in about 10-20% of cases the VZV virus reactivates later in life and causes a more severe presentation known as shingles. It is also treatable with the same antivirals that we take for HSV, and this kind of recurrence is more common in immunocompromised patients like those with HIV/AIDS. Also, the later in life a person contracts VZV, the more acute the symptoms are likely to be because of the lack of vaccine effect. This is why doctors ask if a person had chickenpox as a child. Finally, the reason I picked the picture from earlier is that shingles can reoccur over a much larger area than HSV usually does (kids have chickenpox all over, so the virus lives in potentially all sensory ganglia along the spinal cord). During clinical presentations of shingles, usually only one or a few of these ganglia have reactivated virus. Therefore, symptoms will only show up within specific margins defined by regions of the skin that have sensory nerves sending fibers to only those spinal cord levels. These levels or territories are called DERMATOMES and are mapped out on the body: http://wardwiki.com/images/thumb/6/6c/Dermatomes.jpg/850px-Dermatomes.jpg

That is why in the picture there is such a clear margin between the blistered skin and the unaffected skin, and also why I asked if this was the case on the backs of PHM's arms.

Wow. I'm with WCS on this one. It's going to be great having you around, dr_h_positive. ;) A fresh medical perspective is an awesome complement in our community. I love your specificity, depth and breadth of your answer. Big hug and many, many welcomes!

Plzhelpme:

The one thing that occurs for me is that it sounds like you have been going to a family doctor - I think you are right to go to an OBGYN - sadly a lot of family Dr's are behind the times when it comes to the latest testing and info on Herpes.

Dr_h_positive:

LOVE the info and I think it would be GREAT to put this in a specific information post that we can send the info-freaks like me and Adrial to when they want to know more detailed specifics. I mostly knew all that but I am not sure I could have articulated it nearly as well. And glad to have seen that photo of shingles - somehow I didn't know it could go down the arm like that - all the folks I know who had it had it mostly in the trunk/midsection of their body.

The word "herpes" comes from the Greek "herpein", which means "to creep" and refers to the ability of the virus to live silently in the body during dormant stages of its life cycle. You know, IMO we need to include this in the educational info .... I think it would help people to get the message about how this virus can hide for much of your life.

:)