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    Lois McGuire, R.N., M.S.N., W.H.N.P.

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  • Nov. 25, 2008

    Herpes prompts many questions

    By Lois McGuire, R.N., M.S.N., W.H.N.P.

146 comments posted

You have had many questions regarding herpes (HSV). This is a big topic, and so we'll look at different aspects of it over the next few weeks.

Genital herpes is common, affecting both men and women. According to the Centers for Disease Control and Prevention, the herpes simplex virus is present in as many as one in six teens and adults in the United States.

Here are some of the areas that we'll cover:

  • Types of herpes
  • Categories
  • Symptoms
  • Frequency
  • Diagnosis
  • How it is spread
  • Treatment
  • Suppressive treatment

Types

Herpes is a virus. There are eight human herpes viruses. They are:
  • Herpes 1 (HSV-1): traditionally thought of as cold sores or fever blisters
  • Herpes 2 (HSV-2): traditionally thought of as genital sores
  • Chicken pox and shingles
  • Epstein-Barr: a common cause of mononucleosis
  • Cytomegalovirus: serious when contracted during pregnancy
  • Human herpes virus 6 or roseola: a type of measles
  • Human herpes virus 7: causes a rash
  • Human herpes virus 8: causes Kaposi's sarcoma, an infection seen mostly in AIDS patients

I only tell you the above mentioned types to round out the discussion on herpes. The rest of this blog will address HSV-1 and HSV-2. If you have questions about the other types of herpes, please contact your provider.

Categories

  • Primary refers to an outbreak that occurs in a person who has never had HSV-1 or HSV-2.
  • Non-primary occurs when a person already has HSV-1 and now has been infected with HSV-2. The existing antibodies to HSV-1 may keep the outbreak from HSV-2 unnoticeable, meaning the newly infected HSV-2 person doesn't have symptoms. Up to 80 percent to 90 percent of first time genital outbreaks have no symptoms. This explains the statistics above.
  • Recurrent is just that, recurrent. People with HSV-2 have an average of 4-6 outbreaks per year. This can vary greatly from person to person. Some people can have more than one per month and others may only have one every few years.

Next week, I will begin with symptoms of HSV-1 and HSV-2. Let me know what questions and observations you have.

146 comments posted

blog index
  • February 12, 2009 11:11 a.m.

    If both partners have HSV-2 do they have to use condoms? We are both not taking any meds - as we both have the virus. Is oral sex okay?

    - Lisa

  • February 11, 2009 9:50 p.m.

    I was just diagnosed with type 2 a couple day ago. I have been faithfully married for 30 years and I am devastated! I feel betrayed and worthless. I am in severe pain from my waist down and can not ever imagine wanting to have sex again, nor anyone wanting me. All of the literature talks about how to be sensative when telling your partner, but that does not help me at all. All I have to look forward to is to hear how he was unfaithful to me and now I have to live with that knowledge every day, the rest of my life, as I take my medication. Hard to be positive right now.

    - pat

  • February 11, 2009 7:48 a.m.

    Don't upset by HSV. Many people can manage it and have a good marriage. You can check their tips on a Herpes datign site" HerpesLoving. com". Most of the users on that site are seeking love

    - cala

  • February 7, 2009 10:46 p.m.

    HR, Does your dr know that you are trying to protect a loved one who is not infected? Suppression therapy to protect your partner can be fairly cheap if you use acyclovir. It is on WalMart's generic $4 list. Always use condoms.

    - Deb

  • February 7, 2009 12:55 p.m.

    I have just been diagnosed with HSV 2, which I never had any idea I had, as I've never had any symptoms. I told my relatively new partner, who has tested negative. He has been understanding but is very concerned about being infected. What is the best way to have a SAFE sexual relationship now? Also, my doctor says I should not be on continuous medication because I don't have symptoms - is this true even with an uninfected partner? Thank you!

    - HR

  • January 26, 2009 9:27 p.m.

    TM. Yes, oral sex can spread HSV 1 to the genitals.

    - Deb

  • January 26, 2009 4:11 p.m.

    Very interesting discussion. I did not see an answer for Kathleen's question. Can you please provide an answer?

    - TM

  • January 22, 2009 3:49 p.m.

    DM Glad to hear you saw your dr. today. I've had herpes for a long time--not even sure when I actually got it. Was married for 23 years and it wasn't a problem. Now that I'm a widow I'm being very careful. My first relationship we both had herpes so didn't use any precautions. Now I'm with someone who doesn't have herpes and he's very understanding and I use suppressive therapy (acyclovir) and we ALWAYS use condoms. I'm 54 years old and herpes does not define my life. For me it is just an inconvenience and my outbreaks are usually not much. With suppressive therapy I haven't had any outbreaks. Good luck to you. Would your boyfriend have bailed on you if you had cancer? At least herpes won't kill you. Just look at this as a learning experience and now you know you have so can take proper precautions.

    - Deb

  • January 22, 2009 1:41 p.m.

    Thanks, Deb for your prompt response. I saw my primary physician today, received some anxiety medicine for temporary relief of my sad mood and I know these feelings will pass. I look forward to asking questions in the future and reading your response.

    - DM

  • January 22, 2009 12:26 p.m.

    DM Yes, there are other men who will be accepting of you for who you are. You could have had HSV II for a long time and never have had an outbreak--that's what makes this so prevalent in the population--people just don't realize they have it. You are worthy of someone who will accept you unconditionally.

    - Deb

  • January 22, 2009 11:20 a.m.

    I was diagnosed 2 days ago. I am a 44 yr old woman. I was entering into a new relationship and we both decided to be tested. I went for my test first and I was tested for everything. I am negative for all diseases except HSV I and II. Thank goodness!I knew I had HSV I. I had fever blisters since I was a little girl, I had a very stressful childhood. I haven't had a HSV I outbreak in years. But I was devastated upon hearing I am HSV II positive. My ex-partner and I say "ex" because when I called him the day I found out he was very positive and had all kinds of solutions,but now it seems he has changed his mind. I am almost more upset at the fact that he is bailing on me then the fact that I have this "skin condition". My heart is really hurting. My ex partner asked if I would consider getting another test - a second opinion - I have told him no but I am wondering if I should now. I am requesting my results be mailed to me. I have been under a tremendous amount of stress the past year and I have never had any symptoms, not even the herpes simplex on my lips and I mention this because I read that stress can bring on an outbreak. I am an avid runner and am physically fit. Can a person have it and never have an outbreak? Could I have gotten it from my mother at birth? I don't want to live my life alone but will I ever find someone who wants to be with me? Could I have had an episode and not have realized it?

    - DM

  • January 19, 2009 9:47 p.m.

    Kathleen, yes, oral herpes can be transmitted to the genitals by oral sex. If you are then infected, you have HSV I in the genital area. AGG, You may be okay, but to know for sure will have to wait 3-4 months before a blood test would show if you have antibodies to herpes. It is usually more difficult for a male to be infected. From now on use protection all the time and she needs to keep taking Valtrex.

    - Deb

  • January 19, 2009 3:34 p.m.

    My partner and I had unprotected sex 3 times, one time protected. She now comes out of the closet and tells me that she has had genital herpes since the age of 17 but has been treating it with Valtrex. What are the chances that the virus has been transmitted to me.

    - AGG

  • January 19, 2009 2:55 p.m.

    can you get a std from an from your partner if they have a urin infection

    - j

  • January 18, 2009 4:48 p.m.

    can you get genital herpes if your partner has a cold sore on his lip and performs oral sex?

    - kathleen

  • January 18, 2009 2:33 p.m.

    What is the latency of HSV 2?

    - ann

  • December 30, 2008 11:31 p.m.

    I am very interested in finding out if any studies have been made on the long term effects of herpes on the immune system in general. I have had it for approximately 30 years and suffer from moderate fibromyalgia and am having elevated antibodies showing some autoimmune thing going on. Is there any effect on the human body from having a long term virus? Thanks, Liz

    - Liz

  • December 24, 2008 1:29 p.m.

    Dear Good Guy, I tried to find where you read the information on WebMD.com. First of all, I want to clarify that we are talking mouth to mouth kissing. Type 2 can be transferred to your partner by kissing if you have Type 2 in your mouth. If you have you have Type 2 of the genital area only....kiss away! Secondly, do not take any unnecessary chances with a person who has herpes. Always insist they use suppression and a barrier. You may be lucky enough not to get herpes from them but I would not take the chance.

    - Lois McGuire

  • December 24, 2008 10:08 a.m.

    my female partner recently learned she has hsv-1 of the genital area. so i went and got tested. dr. said i was exposed to the virus and have antibodies. i've not had any symptoms of mouth or genital area. what do my partner and i do now? we've always had sex with condom but do we now need to limit activity in any way? will i get an oral or genital outbreak by engaging in oral sex? not clear on what it means to be exposed...how do i know if i have oral/genetal and how do i prevent? help. thx.

    - tony

  • December 20, 2008 7:46 p.m.

    What about the cream you can put on the sores? I've seen it on the Canada Pharmacy lists...just curious if it speeds healing....also Is it possible that you feel an outbreak coming on...itching in a spot and your glands being swollen...I felt an outbreak coming on and I doubled my medication acyclovir and I never had an outbreak...is it possible? thanks

    - cynthia

  • December 20, 2008 7:05 p.m.

    Hi Lois, I read some info on hsv2 on WebMD.com and wanted to confirm a couple of things. 1. Type 2 herpes cannot be transferred by kissing. 2. An uninfected person can receive oral sex from an infected person and not get it. Thanks, a good guy

    - a good guy

  • December 18, 2008 8:20 p.m.

    Hi Guys: Been a while. Well the "OTHER" diagnosis that my doc though might be a possiblitiy did not come back positive either. So at this point we don't know. The H test was not just a culture, it was a PCR. He recommends at this point we just wait and see if I have another outbreak. He said on visual exam if they were taking a picture for a textbook example of H, what I had would not be viewed as a good example; however, states it could be. If I have another outbreak, I'll go in right away and have another test. Until then, I've gotten some of my questions answered, and I've go too much life to live to let this get me down too much. He has reservation re: blood test, so we won't be doing that at this point. Take care everyone.

    - Elaine

  • December 10, 2008 6:49 p.m.

    Val: Don't you hate it when they are out of town when important stuff is going on...sure makes it hard. I'll keep you in my thoughts and prayers. Good luck.

    - Elaine

  • December 9, 2008 10:57 p.m.

    Lois, Thanks so much for your prompt answer. I'm sure I'll have many more questions as I learn more about all of this. I look forward to your next blog.

    - Val

  • December 9, 2008 10:45 p.m.

    Elaine, The scripture is exactly what I needed, very uplifting. I believe things happen for a reason even though we might not know why at the time. In any case, I couldn't have lived with myself if I would have allowed someone else to learn of getting this disease, via surprise, the way I did. Again, I thank God that he is negative. I prayed, over and over, that he would not get this disease, even if it meant that I might lose his friendship. I'm learning, quite quickly, that this disease also brings out the true character of those people that are directly involved. The compassion that I felt from him was truly amazing. We have not had a chance to talk since he received his good news as he is out of town on business. I am so happy for him but equally unhappy for myself because I don't know what the outcome will be. I just have to trust that no matter what happens with us, that it is meant to be.

    - Val

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