Dr. Rob answers questions about herpes, Page 1

Do you have any questions or concerns about what Herpes is, how it's spread, about the virus itself?
Receive advice from Dr. Rob Keller, a Doctor who devoted much of his life to the study of viruses and Sexually Transmitted Diseases.



Dr. Rob explains

20% of oral herpes is transmitted genitally

Dear Dr. Rob:

Some co-workers of mine were debating the issue of herpes. One of them believes that everyone carries the strain of herpes within their body. The other believes that you have to come into contact with herpes from another source in order to get it. I am quite confused and don`t know who to believe, could you help me with this.
From: Confused in Carolina

Dr Rob's Response:


Dear Confused in Carolina:

Very good question! You do not "carry" herpes; you "contract" herpes from someone else or something.
[415 ]

Dear Dr. Rob:

I have a couple of questions, I`ve had HSV1 cold sores on my lips all my life, so I`ve been a little paranoid about contracting genital herpes now that I am older. About two years ago, I had some redness after sexual intercourse and I went to see my doctor. The redness had no lumps or lesions, which I characteristically would see with my HSV1 infections along with no pain or real itching. My question is would a herpes genital infection look and feel much like an infection I am used on my lips? I went back to the doctor just because I wanted piece of mind...at my earlier visit he dismissed the redness as irritation and said it was not typical of a Herpes infection. I had a HSV1/HSVII type specific blood test done for piece of mind, but the only issue is obviously the HSV1 would come back positive for antibodies because I have had HSV1 cold sores on my lips all my life; HSVII was negative. How can I distinguish between HSV1 on my lips and genitals?

Fast forward two years to current...I recently had sexual contact with a condom and during sex I began to get irritated in my genital area due to the rough contact. The next day I had some redness and irritation that lasted for 2 days and went away...no blisters, no swelling, and a little itching. I guess my main question is would a Herpes genital infection be very similar to the infections I have on my lips and should I be concerned about this latest irritation two years later? What testing can I do to make sure that I do not have genital herpes once and for all and how would I be able to separate between HSV1 on my lips (which I would be positive for on a blood test due to my oral cold sores) and HSV1 on my genitals? Sorry for the novel, I appreciate your expert opinion.
MJ

Dr Rob's Response:


Dear MJ:

A quite long question, but a simple answer: you can`t. Oral Herpes or HSV1 is, in fact, the cause of lesions in 20% of genital herpes so that the lesions can occur either place. The difference is that Type 1 typically occurs in the oral area and Type 2 typically occurs in the genital area, but there is at least a 20% over lap. I would repeat the Herpes Select Test that you had, as that will answer your question.
[414 ]

Dear Dr. Rob:

Is it true that if you already have the herpes 1 virus that you are not likely to get the herpes 2 virus?

Dr Rob's Response:


Dear Poster Asking about Herpes Type 1 and 2:

Herpes 1 and Herpes 2 are two distinct viruses. Getting one does not preclude getting the other. Most Herpes Type 1 is transmitted orally. Most Herpes Type 2 is transmitted sexually. But the fact is, 20% of genital herpes is transmitted orally and 20% of oral herpes is transmitted genitally.
[413 ]

Dear Dr. Rob:

I have a question in relation to the Immunoglobulin value in a person infected with herpes simplex virus. Please explain IgM and IgG.

Dr Rob's Response:


Dear Poster Who Asks about IgG and IgM:

Initially the antibody that appears is IgM. It is non-specific but it occurs very rapidly. The more specific antibody and the one that will control infections is the IgG antibody and that appears later. As a result during the initial outbreak, one would expect IgM and over time the IgM would be replaced by IgG. Were you to contract a second dose of herpes, it would be IgG not IgM that would increase.
[412 ]

Dear Dr. Rob:

I contracted Genital Herpes 17 years ago. I am currently seeing a guy and we went to a hot tub and had intercourse and he performed oral sex on me. He knows I have the virus and chose not to protect himself. He felt that he could not get infected because the chlorine in the water would kill the virus along with the hot water? It has been over a month since the hot tub encounter and he has not shown any signs of being infected. Can hot water and chlorine kill the virus?
Concerned in Detroit

Dr Rob's Response:


Dear Concerned in Detroit:

I am not aware that hot water or chlorine, present to the extent that would be in a hot tub, would preclude the possibility of contracting herpes through oral sex. On the other hand, it is quite possible that at that time you were not shedding, and therefore, he did not contract the virus. Having escaped the bullet once, I would not try to repeat that miracle.
[411 ]

Dear Dr. Rob:

I’m a 28yr old female and I just had my annual checkup and I was tested for everything, including having blood work done. My doctor told me that I had been exposed to herpes 1 and 2, but there was no way of knowing if I had the disease unless I had some sort of outbreak which I’ve never had. By being exposed to it, does this mean that I have the disease or could I have been exposed and not carry the disease? Is this possible?

Dr Rob's Response:


Dear Poster Asking about being a Carrier:

Your doctor is somewhat misinformed. The fact that you have antibodies, if they were discovered doing a Herpes Select Test, means that you have been exposed to that virus, and having been exposed to that virus and having the antibodies means that you get that diagnosis.

Herpes is forever, but you can protect yourself using Lysine 1 gram twice a day to reduce the number of outbreaks if they ever occur.

It is of significant note that many people develop herpes without ever having outbreaks.
[410 ]

Dear Dr. Rob:

I`m so confused I have had HSV 1 since I was very young. Recently I discovered a sore on my genital area. I haven`t had sex with any infected people. Is the virus still considered HSV 1 even if it`s on the genitals?

Dr Rob's Response:


Dear Confused:

If you’ve had Herpes Type 1 for a long time, there’s no guarantee that it is, in fact, Herpes Type 1. The Herpes Select Test has been present between 10 and 15 years, and it is the only one that truly distinguishes between Herpes Type 1 and Type 2. It is unlikely that a lesion on your leg would be Type 2 without any sexual contact, but it is not impossible that the Herpes Type 2 has been there for a long period of time, even without lesions. The clear-cut way to discern what is going on is a Herpes Select Test.
[409 ]

Dear Dr. Rob:

I was recently with a girl and my condom fell off. We realized this right away and I cleaned up and put on a new one, but I was just curious if herpes or other STD`s can be contracted that quickly. I don`t have herpes or any symptoms, but I don`t know the girl or her history. How long after sexual contact with her should I wait to get tested and how long does it take to show up. Do you think it is possible or probable to contract anything in that short amount of time with a condom falling off for a second during intercourse (if she were to have something)?
Thank you for your input.

Dr Rob's Response:


Dear Poster Asking about a Condom:

Yes, herpes can be transmitted that quickly, if there are, in fact, any sores or breaks in the skin of either partner during intercourse. Given the fact that you cleaned up very quickly, it becomes less likely, but it is clearly possible, and I would suggest that you wait 2 to 3 months and get a Herpes Select Test done to put your mind at ease.
[408 ]
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