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National Cervical Cancer Coalition


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PostPosted: Tue May 26, 2009 5:15 pm 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
So glad to find this site- so hard to get good info even from doctors.
My husband had a first outbreak of genital herpes on the mons pubis early April; it was cultured. He has not yet had the blood test. I did have a blood test and was told I am negative for both strains. We have an 8 week old baby and have not engaged in vaginal sex for several months secondary to the pregnancy/delivery. We did, however, have oral sex probably 2-3 days prior to his outbreak. I had blood tests both 2 weeks and 4 weeks post his outbreak and plan to have another at 12 weeks post the outbreak. I am unaware of what kind of blood test the lab used. He was put on daily valtrex about 7weeks ago when it was cultured. Although we haven't had vaginal sex again yet, I did stimulate him manually the other day and did not use a condom for this since the outbreak had been on the mons pubis, is cleared up and he's on the valtrex. Then I read that the virus may also be in semen and became concerned. My husband and I have been together for 7 years and I believe he got this infection prior to dating/marrying me. As he's not had a bloodtest, we are not positive if it's strain 1 or2, however, he's never had a cold sore, so we imagine it is likely 2. I have several questions:
- I don't know the type of blood test I was given other than i've been told I'm negative for both strains at this time. Are there many false negatives with specific tests? I plan to return at week 12 but have read that specific tests don't always yield accurate results because of what Ig they test for.
- I am most nervous about our oral sex encounter several days prior to him having had his first outbreak-we had absolutely no idea he had this. Presuming this is strain 2 is there a strong likelihood I've contracted this in the mouth or on my face? Again, the outbreak was on the mons pubis- not the penis? I am also very concerned for our baby if I did contract it on my face. I have no symptoms, but am aware of viral shedding. I kiss and nuzzle my baby. Is there a strong likelihood I could give this to my baby if I would be shedding virus prior to having an initial outbreak- assuming I contracted it during the oral sex encounter?
- Again with the outbreak on the mons pubis- do I increase my chances of contracting the disease- on my hand of all places- from stimulating him without a condom? And when we do have vaginal sex again, do I protect myself with use of a condom since it doesn't cover the mons pubis?
- Given that we've been together for 7 years and according to the blood test he hadn't passed it to me during those years, is he more contagious now that he's had an initial outbreak- or- do I have even less of a chance of contracting it since he's now on daily valtrex?
- We'd like to have another baby in a year- is this safe?
Thank you so much for any information! Sorry so long.


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PostPosted: Wed May 27, 2009 5:53 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
Welcome to the board :)


At this point I don't recommend any further blood testing for you as long as you confirm that you were tested with the igg herpes blood test both times ( and not the igm ). If you had contracted hsv2 orally from your oral encounter a month ago, you would've had obvious symptoms by now so since you haven't, you can stop worrying about that part. If you were properly tested then you know you don't have it from 7 years of being together so no need to continue with blood tests at this point. I recommend no more herpes blood testing for you unless you get obvious genital symptoms once you start resuming sex again ( and go and be seen and get a lesion culture then ) or if you need the peace of mind, once yearly. When you get pregnant again, be sure to get tested again then and then come back here so I can help you more ( no need to overwhelm you with all this info now ).

Manual stimulation is very low risk and not really something to worry about as long as the skin on your hands is intact ( no cracks or open wounds ).

The location of his ob's is meaningless to be honest. He is shedding from the area of obvious lesions as well as from the entire anogenital area. When he has obvious symptoms, avoid sex until they are gone. His being on daily suppressive therapy will help keep those few and far between.

Keep in mind that you two have done nothing and he hasn't transmitted this to you in the 7 years you've been together. Try not to let this become some overwhelming thing in your lives together.

betsy

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PostPosted: Wed May 27, 2009 7:21 am 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
thank you very much for the information- so helpful. i will call my obgyn to ensure I was given the test measuring the correct thing. My biggest concern has been for the baby, as I breastfeed and kiss baby of course, so we have lots of skin to skin contact. I have one other question regarding the oral- mostly because i think i just need extra reassurance. I've had a tendency toward occasional cankersores my whole life particularly after eating or drinking certain fruits/juices. I've had a couple times of what i'm almost positive are just cankersores since the encounter. they don't hurt and go away pretty quick. i have two right now but had tomato juice the other morning, plus lots of berries lately since they're in season. Are cankersores pretty easy to tell the difference from relative to herpes? Is it likely I would definitely know if a small place was a cankersore versus a lesion? What is a mouth lesion like? Thanks. I don't want this to be a big thing in our marriage- we were just thrown a curveball and I want to educate all of us so that I- and we- don't worry unnecessarily.


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PostPosted: Wed May 27, 2009 10:23 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
I just picked up a couple of quarts of fresh local strawberries myself at market this morning!! They are smelling up the whole house in a good way!!!

Canker sores are not due to herpes. They are genetic and aren't contagious. You've been getting them for a long time now, no reason to doubt that they aren't your regular run of the mill canker sores you are prone to getting. Don't they just annoy the heck out of ya?

betsy

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PostPosted: Thu May 28, 2009 9:57 am 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
i have another question. You wrote that if I had contracted herpes during the oral encounter I would have had symptoms in the first month. But my hubby didn't have a break out for 7 years. Is it because it was an oral encounter rather than vaginal encounter that symptoms would show up more quickly? I ask you to reaffirm this point so I don't get neurotic every time I have a cankersore:) Also, I did call my obgyn and the test did indeed test the Igg level (as well as the Igm), so that is good news. May I also ask what your background is? You have more knowlege on this than I've found anywhere.
Thank you again.


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PostPosted: Thu May 28, 2009 11:34 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
I am a nurse. I've also had hsv2 myself for 22 years. I keep up to date on the info and attend the cdc std conferences and even presented a poster at the last one with fredo :)

The thing is - most folks who have genital herpes, just aren't noticing symtoms. It's not that they aren't having them, they just aren't having "classic" blister like lesions that are very painful to make them suspect that something is going on like genital herpes. Only about 20% of folks are truly asymptomatic. Your hubby probably just had very mild symptoms up until this time and didn't think twice about them.

When you are hsv negative and then contract hsv2, you tend to have obvious symptoms with 2-20 days of being infected. You don't describe anything that sounds like a hsv outbreak orally.

betsy

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PostPosted: Fri Feb 19, 2010 10:18 am 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
It has been almost a year now since my husband was diagnosed. I have a couple of new questions. He has still only had the one outbreak and has been on valtrex since that outbreak. My questions are:

How safe is longterm valtrex therapy? We would like him to be on it through a second pregnancy and an additional year of breastfeeding. Is there any info on the virus mutating and becoming more resistant or future outbreaks not responding as well if you are on valtrex for long periods of time?

We are going to start trying to get pregnant again this month. As far as we know, I have not contracted herpes to this point. What do I need to know about getting pregnant, testing, the possibility of contracting while trying to conceive, danger to the fetus? We are considering not having sex for the duration of the pregnancy after we conceive- do you think this is a good idea or are we being overly cautious?

Thanks for your time, much appreciated!


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PostPosted: Fri Feb 19, 2010 12:46 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
no risk to long term usage of valtrex suppressively. We have info on acyclovir used non-stop suppressively for 20+ years now ( valtrex is an acyclovir prodrug ). We also have info on 10+ years of valtrex used non-stop suppressively. No issues at all.

You should get tested again when pregnant for herpes. If you are negative, you and hubby should discuss using condoms for the rest of the pregnancy along with his staying on suppressive therapy to protect you even more. At the start of your last semester, retest for hsv2 and if still negative, discuss if it's worthwhile to avoid sex until after delivery. No need to give up sex the entire pregnancy though :) ( tell hubby the bill for saying that should be arriving shortly....h ehe he )

best wishes and I hope you conceive quickly! Hate that monthly wait and see game...ugh.

betsy

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PostPosted: Fri Feb 19, 2010 3:09 pm 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
thank you for the info:) Just one more question, what if I would test positive and/or have outbreak after finding out i'm pregnant? Do they just put me on valtrex too?


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PostPosted: Fri Feb 19, 2010 5:41 pm 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
yes if you contract herpes during pregnancy they will treat you for it. if you contract itduring your 3rd trimester, it's recommended that you have a planned c section no matter what. if you contracted it during 1st 2 trimesters or before pregnancy, they recommend suppressive therapy in the pregnancy doses for the last month.

cross those bridges when you come to them. I'll leave a light on for you :)

betsy

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PostPosted: Fri Mar 19, 2010 10:02 am 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
So, I am officially 5 weeks pregnant! You mentioned I should be tested in the 1st trimester to see if I continue to be negative. My OB office doesn't typically start seeing patients until between the 8th-10th week of pregnancy (per receptionist). My first appt is scheduled for sometime during the 9th week. Do you have any thoughts on if I should pursue getting an earlier appointment so they can go ahead and do another blood test earlier in the first trimester or is waiting until the 9th week fine? Thanks for your thoughts.


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PostPosted: Fri Mar 19, 2010 10:36 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
CONGRATS!!! You two are quick!!! Best wishes for a very healthy pregnancy :)

It's fine to wait and get tested at your 9 week appointment when they draw 10 quarts of blood for everything else :)

betsy

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PostPosted: Fri Apr 16, 2010 8:44 am 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
so I went for my first appt for this pregnancy yesterday. i requested that they go ahead and test me again for herpes, and the midwife had me tested for the recent infection antibody since i've already had the long term antibody test. the results should be back in a few days. also, like you, she said that it is not necessary to abstain from sex during the entire duration of the pregnancy. she did also mention how dangerous an initial outbreak can be for the baby if it happens during pregnancy and mentioned brain damage was possible. makes me cringe to even write it. i guess i need some clarification on why abstaining isn't recommended if the consequences of contracting and having an initial outbreak during pregnancy are so dire? is it a definite the baby would be affected if i've converted to positive and have an outbreak while pregnant?
also, if this test comes back positive, how protective would taking valtrex be for my baby? i sort of felt my midwife was a little vague, not sure if it was to not scare me more than necessary or if it's because she thinks the odds of problems or low, or if she just doesn't know.
thank you for your input!


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PostPosted: Fri Apr 16, 2010 9:20 am 

Joined: Mon Feb 05, 2007 11:47 am
Posts: 5443
Location: PA
the igm test for herpes is a greatly flawed test and we never recommend its use. if it comes back +, do not assume it means you really have hsv2. the igg test is the more appropriate test to have done and far more accurate.

It's still if I recall properly only a 5% risk of transmission to the baby in utero if you do contract hsv2 during pregnancy. if the weather man told you there was a 5% chance of rain, would you cancel a trip to the beach? really not worth abstaining for 9 months for that low risk. your hubby can take daily suppressive therapy and you can even resume using condoms to keep your risk of contracting hsv2 very low.

As far as I know, we do not have any studies to show if the outcome for the baby is improved if you take valtrex to treat a newly acquired hsv2 infection while pregnant.

betsy

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PostPosted: Fri Apr 16, 2010 10:30 am 

Joined: Tue May 26, 2009 4:38 pm
Posts: 13
thank you for your reply; yes, i recall when i first started looking that some of the testing was flawed. i just read through the igm testing info on top of board talking about false positives and the other issues with this test. can this test also produce false negatives as well? do you think if this test comes back negative that i should have them do an igg immediately or just wait until beginning of 3rd trimester. i believe the only igg tests they did on me were last year a couple weeks and a couple months after we found out about my husband.

5% chance for problems with initial outbreak during pregnancy; that makes me feel much better!
thank you for your input, this is a really wierd and challenging condition to navigate!


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