A friend and former lover of mine (we were lovers over 20 years ago) recently was told she tested positive for herpes (though the doctor didn’t tell her which virus). Unfortunately, the doctors explaination was a bit puzzling to my friend…and the doctor himself seemed to be a bit puzzled. So, I thought I’d come here, explain the situation and see if anyone here knows more…and maybe can advise my friend on whether or not she should go to another doctor.
When my friend was in high school, she started to get sores on her belly and her bottom (but not on her genitals or anus). When she first started getting them, she went to the doctor and was told it was ‘shingles’ (but without any blood or tissue tests). Throughout her life, when she would infrequently get these sores (once or twice a year, usually brought on by stress or illness) she assumed it was this ‘shingles’ thing and would pay it no mind.
Recently she had her yearly outbreak, and just happened to be at the doctors where they took a blood and tissue sample. Appearently the tissue sample ‘didn’t culture’ (whatever that means), but the blood sample came back positive. The doctor, however, told my friend that the chances of her infecting someone else were ‘nil’. THough this seems odd (to me), it seems to be the case, as none of her former lovers (including me) OR her husband for the last 9 year has ever seemingly gotten anything from her. I know in my own case, we were lovers for about 3 years, living together, and at least as far as I know, I’ve never gotten a sore anywhere on my body (except a cold sore on my mouth VERY occationally, which predates both my relationship with this woman AND my own sexual activity…I started getting them when I was a baby). Neither has any of her partners before or after me, or her husband.
My question is…how could she HAVE herpes and yet not be contageous (or I suppose, more accurately, very minimally contageous, according to both the doctor and the fact that seemingly none of her partners ever contracted the disease)? I thought herpes was HIGHLY contageous, especially if you were having unprotected sex. Should my friend go get a second opinion? Go have another sample/blood test (whenever the sores come back…probably in a year or so)? What about her former partners (like me)? As I said, I’ve never had a sore…nor has my wife and we’ve been married for over 15 years. What about her husband? He’s never had a sore either. Should he get tested too?
Clarification: you can’t catch shingles from someone with shingles. You might, if you’ve never had chicken pox or the chicken pox vaccine, catch chicken pox from someone with shingles, but only a few people with chicken pox go on to develop shingles, and usually years later.
I don’t know if this is a helpful answer or a followup question, so bear with me. I’m not a doctor.
I never made too much of a differentiation between HSV-1 and HSV-2 other than the typical location. If you had a real cold sore ever in your life, you have herpes. If you have had a genital herpes sore, you have herpes. You can be just as infectious with either, and your duty to inform others is probably about the same – before kissing, sexual contact or even sharing beverages. However, somehow HSV-2 has gotten stigmatized and HSV-1 is paid no attention to, so my own personal approach has become to HSV-1/-2 (and several silent strains of HPV as well) as facts of life – there isn’t that much you can do other than completely avoid other people or be lucky to avoid getting it, so we just have to wait for a vaccine or an anti-viral.
As for infectiousness, you could be more infectious than she is. You had a cold sore once, but you could be shedding the virus and not know it. She could simply not be shedding the virus and only be contagious during outbreaks. You simply don’t know.
(Doctor-dopers, feel free to correct anything above)
I forgot you mentioned shingles, so that’s a third type of “animal”, but calling shingles “a type of herpes” while somewhat medically accurate (it is HSV-3) is about as socially accurate as saying that someone who has chickenpox or mono has “herpes”. I mean they are all contagious to a certain extent, and all four viruses mentioned can cause some sort of a contagious situation later in life, for EBV and HSV-3 that is much more rare than it is for HSV-1 or HSV-2.
Umm, doesn’t that mean that you can catch singles from someone with singles? If shingles can infect somebody with chicken pox and that chicken pox can result in shingles in that person, shingles in person A can eventually result in shingles in person B, however unlikely, I’d still call that possible.
IANAD, but I do have herpes and have done a helluva lot of reading about it.
A blood test like HerpeSelect will tell you if you have anitbodies for HSV 1 or HSV 2 (or both). If you have the antibodies, it means you have been infected with the virus. If you have a positive virus culture from a sore and a negative antibody test, it means that you are experiencing an initial infection. It takes several weeks to develop the antibodies.
It’s possible she had a positive blood test (something like 80+ percent of adults over the age of 50 are positive for HSV 1, some of whom never have cold sores) but that the sores are not herpes. The only way to find that out is from a virus culture taken from an open sore.
It’s also possible that she has herpes and is minimally contagious. You can only get herpes from another person when that person is actively shedding virus (which often happens asymptomatically), but the longer a person has the infection, the fewer days of shedding that person experiences.
There IS a difference between HSV 1 & 2 (cite), because each virus “prefers” its own location. If you have gential HSV 1, which you can get from oral sex, it is much more difficult to transmit it genitally to another person. It is possible to get oral HSV 2, but almost impossible to transmit it orally. And an infection out of its “home” territory tends to be milder and have fewer recurrences.
Wow, thanks for all the good info! Especially the links. My friend has been freaking out a bit, being told she has the dread herpes, but it sounds to me as if MOST of us have at least type 1. Certainly, it sounds to me as if I have had it since I was a baby, as I’ve gotten ‘cold sores’ since I was around 3. I wasn’t aware that ‘cold sores’ = HSV1…so I assume if I got a blood test I too would get a positive result.
Thanks for all the good info guys. I think that I can have a meaningful and informative talk with my friend (I’m going to print out freckafree’s and WhyNot’s links to give her some reading material on it all) and calm her down. I don’t understand why her doctor didn’t take the time to talk to her about all this, instead of being so layed back about it all…she was serious freaked out yesterday.
Right, that’s why I tried to backtrack, following the rather unlikely scenario. In the US, nearly all of us are immune to chicken pox through either childhood infection or vaccination, long before we’re of intimate relations age. If you are immune, as most adults are, you won’t catch anything at all from a person with shingles.
And remember, in addition to Herpes simplex I and II, there are other Herpes viruses, with varying levels of contagiousness. Some of them are:
Herpesvirus M
Herpesvirus papio
Herpesvirus platyrrhinae type
Herpesvirus pottos
Herpesvirus saimiri 2
Herpesvirus salmonis
Herpesvirus sanguinus
Herpesvirus scophthalmus
Herpesvirus sylvilagus
Herpesvirus T
Herpesvirus tarnarinus
Funny/not funny anecdote: my friend moved to a very small town with a very young doctor who was absolutely stumped by her (my friend’s) child’s odd rash and fever. Could not figure it out in the books. Sent swabs to the labs. Finally declared it “An unspecified herpes virus” and sent her home with symptomatic relief. Two grandmothers in the drugstore on the way home looked at the baby and said, “Why is that child out in public with the chicken pox?!” Yep, young doctor had never seen chicken pox, because all her patients since med school had been vaccinated!
There is an incredible amount of ignorance in the medical community about herpes, unfortunately. My ob-gyn told me that the virus could not be typed from a culture (wrong) and that it didn’t matter anyway because there is no difference between HSV-1 and -2 (wrong again).
There are some other factors that increase the rick of shingles (weakened immune system, use of steroids, age, and more), but I’ll leave those for another thread.
Most cold sores are Human Herpesvirus 1, HSV-1
Most cases of genital herpes are Human Herpesvirus 2, HSV-2
(both 1 and 2 can cause facial and genital sores, but the likelihood is different)
Chickenpox is Human Herpesvirus 3, also known as varicella zoster virus
Mono is either Human Herpesvirus 4 (also known as Epstein-Barr) or Human Herpesvirus 5 (Cytomegalovirus)
This is all for clarity, I’ve never seen anybody continuously refer to these as “Human Herpesvirus” and it’s typically abbreviated HHV-x (like HHV-1, etc.)
All the herpesviruses share a similar structure, and you can read more about that here
