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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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In the past I was diagnosed with HSV2. I dont get any symptoms

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In the past I was diagnosed with HSV2. I don't get any symptoms anymore at the sight of infection. However recently. I've got it worse in another location. I've always wore a condom since then, and haven't been with many people. It seems to weep a lot more, and the clusters might be slightly bigger. Have I got hSV1, or doe's this sometimes happen with HSV2. Its been 20 years since I was first diagnosed
It will help if you could provide some further information:
Have you ever had cold sores in the mouth, including as a child?
Was the original diagnosis made by a blood test?
If so, was a blood test for HSV1 done at the same time?

Customer: replied 3 years ago.

I've never had cold sores on the mouth. I was diagnosed with a blood test for HSV2 20 years ago. I don't get a attack at that site anymore. I was tested for everything at that time, and only had HSV2. It was a long time ago. The attack I'm getting now is at the base of my penis. I'm thinking maybe the condom wasn't enough.

Thank you for the additional information.

It certainly is possible that you could have developed HSV1 n the genital region. Most people get infected with HSV1 as a child or young adult, but for those that have not yet been infected, it is possible to become infected. In those people that are not yet immune to HSV1, they can become infected in the genital region if so exposed, although it still will cause oral infections more often.

Therefore, yes, if you are having symptoms that are substantially different than the previous symptoms caused by HSV2, the primary concern would be that you have become infected with HSV1. It cannot be definitely determined based solely on symptoms, as there can be an atypical presentation of HSV2 over time, but an infection with HSV1 would be the most likely and consequently the greatest concern.

There are two options at this point. Since you know that the HSV1 test was negative previously, then a positive HSV1 antibody test would be very suspicious that these lesions are from HSV1. However, a positive HSV1 antibody test is not specific to the location of the infection. A more accurate test to determine whether these lesions are from HSV1 would be a herpes culture of a lesion with your next symptoms. A culture is most accurate when the lesion is fresh, so it is frequently a challenge to be seen by a doctor in a timely manner, but if a culture can be done timely, it is the most accurate test.

If you have any further questions, please let me know.

Dr. D. Love and 4 other Medical Specialists are ready to help you
I would also note that you are correct that condoms are limited in their effectiveness in the prevention of HSV since they do not cover all of the genital skin. Studies looking at the effectiveness of condoms in reducing the risk of HSV show that they are about 50% effective at doing so.

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