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Goddess1

Is it possible after having no symptoms for 25 years to get reinfected?

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Goddess1

Is it possible after having no symptoms of HSV for 25 years to get reinfected by another partner?

Ok so when I was 18 my boyfriend of 3 years had a cold sore we had oral sex and weeks later I was told I had HSV. From that moment on I have never had any symptoms and even that time the symptoms were not even noticeable. Just recently I got a sore near my rectum and went to the doctor to see what it was and to my surprise it was HSV. I have recently started in a relationship as I am going through a divorce and have been separated. I was intimate with this man " stupidly unprotected" and I'm wondering if I somehow got re-exposed to this virus from him? The symptoms are terrible this time chills, fever, pain, flu like symptoms. I need to find out if I was exposed again to this with him. Is there a way to tell if after 25 years you became re-exposed to the virus? I hear there are blood tests to determine when you were exposed to the antibodies? I would like to know so I can talk to him about this and let him know but I want to know if I infact after 25 years of dormancy could have actually affected him? I feel so alone right now. dirty, unclean, for the past few days all I have done is cry hysterically and feel like I wanted to die. I'm a little better now. I would appreciate a response so I can not feel so alone worthless and afraid. Thank you

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Spock

Reinfected? If you already had hsv2, just no outbreaks, you still had the disease and it never went away. Hsv is a permanent condition, and some people take years to outbreak. If you've already been tested positive, all you're going to do is be told you're positive again. You had it all along.

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goddess8

Not only did you have it all along, you could have passed it to any of your sexual partners you had in the mean time. And you might pass it to this person who you think may have reinfected you.

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victor

HSV-1 genitally only sheds less than 12 days per year so the chances of you spreading it to him are very low. Having genital HSV-1 doesn't protect you from getting HSV-2 so it's possible you picked up HSV-2 from him. You can't be infected with the same virus twice; it doesn't work that way. This could be your first recurrence or an OB of HSV-2. Yes, there are blood tests that will give you an idea when you got HSV, but you have to get tested ASAP after you notice symptoms. For instance: taking a a blood test right after you notice symptoms and results are negative. Retest in 3 months and your results are positive. That would be a scenario of how you know that it's a new infection.

You have HSV-1 genitally. It's not a big deal since over 60-80% of adults have HSV-1 and can't catch it again unless they're immunocompromised or have a new infection before developing antibodies. I'd get your bf tested and if he has HSV-1 as well (either oral or genital; doesn't matter) then he is extremely, extremely unlikely from getting this again.

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Goddess1

Victor, thank you so much for your detailed explanation it meant a lot. I do have another question. How can you tell if its HSV1 or HSV2? Will the blood test show that? I had a culture done bc I had one sore near my rectum and the office called and said it was positive for HSV they didn't say 1 or 2. I didn't have a blood test. Do I need to ask her to do one? I am meeting with my doctor to talk with her further about this on Monday. Can u give me some ideas on what I need to discuss with her. I'm a little confused about the blood test being negative and three months later being positive? I'm sorry for the loaded question just need some answers from someone who cares. Thank you so much.

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goddess8

Goddess1,

Sorry if I may have sounded uncaring. You aren't to blame for the fact that your doctor never explained things to you, nor pointed you in the right direction to seek information about HSV. Doctors seem not to want to make it clear that the virus is here to stay, and some even seem to want to soften the blow because they don't want to upset their patients. I can understand how if you had not had symptoms for a long time that you might believe that you don't actually have it anymore. There is a lot of good information here to read. Good luck in learning about the virus and figuring out what you can about your present situation with your current partner.

goddess8

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victor

@Goddess1 - A blood test will tell you what type you have (HSV-1 or HSV-2), but it won't tell you the location. However, given your description about your bf performing oral sex on you with cold sores, it is highly likely that you have HSV-1 genitally. When you get a new OB, be sure to get it cultured ASAP or within 48 hours of it's appearance so they can type the culture. I'm sure if you call the nurse who cultured it then they will be able to tell you which type it was.

Regarding a blood test and antibodies, antibodies will be detectable at the 3 month mark. Since your first exposure was so long ago (18 years old), the blood test will be accurate. I'm a little confused on how recently you and your new partner last had sex. If it was recent, then a blood test probably won't be able to detect it until about 7 weeks, and it's probably 99% detectable in people by the 3 month mark. You probably have genital HSV-1 from your description of your ex-boyfriend's cold sores, but it's also possible that your new partner had HSV-2 genitally and infected you with that (genital HSV-1 gives you minimal protection from HSV-2, if any) and could have given it to you through genital-to-genital sex. Genital HSV-1 is really mild for most people (although the primary OB tends to be pretty bad) and it rarely recurs, which can explain why you haven't had OBs for so long. It's unlikely that you've passed this on as only 10% of new genital HSV-1 infections are caused by genital to genital sex; 90% caused by oral sex. Further, 60-80% of the population has HSV-1 (mostly oral) so they're highly, highly unlikely to get it from you. Of course it's possible, but it's also possible to run over George Bush in your driveway lol :).

Your symptoms such as flu-like, chills, fever, pain are not indicative of a recurrence. Usually, people only get the flu like symptoms during the first outbreak because it's the first time their body responds to the virus. Your symptoms could be just from being sick or they could be related to a possible infection with HSV-2. You won't be reinfected with HSV-1 since you already have it; it's not a possibility, but this doesn't prevent you from getting HSV-2. If you and your partner both have the same HSV-1, you aren't going to pass it back and forth to each other in other location of the body.

I'd get your boyfriend tested as well since you are now sexually active with a new partner, it's best to know who has what.

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osten
HSV-1 genitally only sheds less than 12 days per year so the chances of you spreading it to him are very low. Having genital HSV-1 doesn't protect you from getting HSV-2 so it's possible you picked up HSV-2 from him. You can't be infected with the same virus twice; it doesn't work that way. This could be your first recurrence or an OB of HSV-2. Yes, there are blood tests that will give you an idea when you got HSV, but you have to get tested ASAP after you notice symptoms. For instance: taking a a blood test right after you notice symptoms and results are negative. Retest in 3 months and your results are positive. That would be a scenario of how you know that it's a new infection.

You have HSV-1 genitally. It's not a big deal since over 60-80% of adults have HSV-1 and can't catch it again unless they're immunocompromised or have a new infection before developing antibodies. I'd get your bf tested and if he has HSV-1 as well (either oral or genital; doesn't matter) then he is extremely, extremely unlikely from getting this again.

I agree that HSV-1 genitally is no big deal. For the most part, HSV anywhere is no big deal.

However, I don't think we should understate the possibility of the transfer of genital HSV-1 to either somebody else's mouth, or somebody else's genitals.

About 60% of Americans have HSV-1 (according to NHAMES). Obviously, the likelihood of having it is lower if we take people on the younger end of the spectrum, and higher as we look at older people. People in the 20-29 year old bracket had 54% infection rates.

Still, if we take the averages, your partner has about a 40% chance of not being mostly immune to your herpes. The potential immunity of your partner should only be considered as a factor if you know for sure your partner is HSV-1 positive already. Otherwise, it only cuts down the likelihood that he or she can get it from you by a little more than half.

You may shed on average "only" 15 days of the year. That means that for, on average, 15 days of the year, you are infectious, and your partner can get it, either orally or genitally, from you. Since nobody ever knows just when those 15 days of the year are, we have to be aware that there is a chance that it may be spread. It's a 1/4 of how much genital HSV-2 sheds, which, if we go by shedding means that you are 1/4 as contagious. I don't think that's enough of a difference to not be concerned about transmission, unless you are already not concerned about HSV-2 transmission.

It's the first time that I've heard 10% of genital HSV-1 cases were from genital-to-genital contact, but I'll accept that. That shouldn't be surprising, since far more people have herpes orally than genitally, and are therefore able to transmit orally-to-genitally. That doesn't change the fact that if you do have it genitally, you can still transmit.

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victor

I'm not understating anything. I recommended that her boyfriend gets tested for HSV-1 because if he has it (so does she) then he is extremely, extremely unlikely to catch it again in another location. What I said was if her boyfriend is positive for HSV-1 then there is really no precautions to be taken since they both have the same virus.

Actually, when you shed less than 12 days per year and have sex on one of those days, there is no guarantee for transmission. Other factors come into play since it's being transferred from it's undesired location to another's undesired location.

Here's the 90%/10% from gracefromHHP http://www.medhelp.org/posts/Herpes/Genital-HSV-1-Questions-transmission/show/1813920

If her partner is negative for HSV-1, of course I would suggest taking precautions. However, I was providing the scenario that if he's positive then it's extremely unlikely that he'll catch it again in another location, which is supported by Herpes Expert Terri Warren. Dr. Handsfield and Dr. Hook will say no transmission risk or one is immune after having a longstanding infection, but I guess anything is possible.

Links for Osten:

http://www.medhelp.org/posts/STDs/Partners-have-different-HSV1-genital--oral-/show/1129351

http://www.medhelp.org/posts/Herpes/Oral-Sex-exposure/show/1837909

http://www.medhelp.org/posts/Herpes/Genital-HSV-1/show/1843133

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osten

Thank you for the link from grace. I'd prefer to see the results of a broad study, rather than a comment with no citation on medhelp.org, but still, the number does sound reasonable enough. Again though, it doesn't in itself indicate that genital HSV-1 is extremely difficult to transmit. It indicates that many more people have oral HSV-1 than genital HSV-1, and therefore transmissions with an oral source are much more likely.

Still, I'm not sure why you provided me with those other links. I made it very clear in my post that I am aware that if your partner already has the same strain of HSV as you, you are unlikely to reinfect him her or her.

Of course there is no guarantee you for transmission on a day that you are shedding. The same applies to HSV-2. My point was that the average shedding days for genital HSV-1 is only 1/4 that of HSV-2. If your partner doesn't already have HSV-1, then while there is certainly a lower chance, 1/4 as infectious is not enough to remove concern for transmission. We cannot assume that anybody is relatively immune unless both parties have been tested, and have tested positive for the same strain.

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lovelyoptimistic

Hello,

If you had hsv, you will alwas have it. One of the forum moderators, ace, also went a long time without her second ob. So it is possible.

Hsv 1and 2 can infect either genitals or oral regions. If you were not typed at your initial diagnosis, you may never know if you were reinfected with a diff strain. Although unlikely...it is possible that you coukd have had both hsv1 and 2 when you first contracted it. We cannot make assumptions about which virus you had based upon the location of your givers infection.

With reocurrences people can still get heaches, fevers, and chills whenever i have an ob i still get a slight fever and eye pain. Other members in the forum can also atest to this.

You need to tell your partner you have hsv. There is always a risk of passing it regardless of how many ob you get. Have him get a blood test. I've also read that antibdies can show up as early as 2 to 3 weeks so depending upon how long it's been since you've had sex, if he shows up positive...again you may not know who passed what to who.

Virus is tricky. So many what if's and unknowns exist. Good luck :-)

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lovelyoptimistic

Also...stats, in my opinion, about transmission give people a false sense of hope. Several people have gotten hsv with only one sexual encounter with their giver. Also, some have gotten it while using protection and antivirals. I only say this bc i don't want you to get the wrong idea and accuse your new partner bc of stats that statei there is no absolute/ minimal chance that you could have spread it to him.; thus thinking he gave you a new infection. Again good luck! :-)

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victor
Thank you for the link from grace. I'd prefer to see the results of a broad study, rather than a comment with no citation on medhelp.org, but still, the number does sound reasonable enough. Again though, it doesn't in itself indicate that genital HSV-1 is extremely difficult to transmit. It indicates that many more people have oral HSV-1 than genital HSV-1, and therefore transmissions with an oral source are much more likely.

Still, I'm not sure why you provided me with those other links. I made it very clear in my post that I am aware that if your partner already has the same strain of HSV as you, you are unlikely to reinfect him her or her.

Of course there is no guarantee you for transmission on a day that you are shedding. The same applies to HSV-2. My point was that the average shedding days for genital HSV-1 is only 1/4 that of HSV-2. If your partner doesn't already have HSV-1, then while there is certainly a lower chance, 1/4 as infectious is not enough to remove concern for transmission. We cannot assume that anybody is relatively immune unless both parties have been tested, and have tested positive for the same strain.

I've seen Dr. Handsfield use the 90%/10% comparison I believe as well as Grace; it's doubtful she just picked that number out of a hat. If you look at the shedding statistics, oral HSV-1 sheds 9-18% of days while genital HSV-1 sheds 3-5% of days; that's quite a difference and it's reasonable to conclude that the reason it's spread more frequently through oral sex is simply because of the shedding rate. Of course transmission is going to be more likely if the source has oral HSV-1 other than genital HSV-1 due to the difference in frequency of the shedding rates. You're right, way more people have HSV-1 orally, which protects them from getting HSV-1 genitally, and the ones that have it genitally can pass it on 3-5% days/year to those without an HSV-1 infection. The odds of having sex on one of those days is rare to begin with, and again, transmission doesn't always occur during shedding. Unfortunately, there is not enough research on genital HSV-1 to settle all the "what ifs" or "could bes", but what we do know is that genital-to-genital HSV-1 transmission seems to be rare. Like I said in my previous post, if one doesn't have an existing HSV-1 infection while his or her partner does then precautions should be taken to reduce transmission. Also, if you look at my first post, I told Goddess1 to get her boyfriend tested to know his status.

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osten

When you say "it's reasonable to conclude that the reason it's spread more frequently through oral sex is simply because of the shedding rate" I cannot agree. It's not "simply" because of that. Obviously that is a factor, and perhaps an important factor, but I think it's unquestionable that a very significant factor (if not the most significant one) is the fact that far more people have oral HSV-1, and therefore, even if the shedding rates were the same, we would expect far more cases of oral-to-genital transfers as opposed to genital-genital transfers. Given that, I don't think that we could say that a 10% figure for genital-to-genital transfers makes it particularly "rare".

I'm also not sure that something shedding 1/4 of the amount (thereby making it 1/4 as transmittable) is so significant a difference as to make it that much less of a concern than either oral-to-genital HSV-1 transfer, or genital-to-genital HSV-2 transfer.

Anyway, I think we are generally agreeing about the numbers, and just disagreeing with their significance.

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victor

You're giving an opinionated response that isn't supported by research in regards to genital-to-genital HSV-1. My answers come from research; we can do the "what ifs" and "could bes" all day, but that still won't change the research. I believe the research that has been done could be better, but working with what they have, the top STD experts and herpes experts think genital-to-genital HSV-1 is rare. STD expert, Dr. Handsfield, has never seen a case of genital-to-genital HSV-1 in over 30 years of practice. If you want to continue to dispute the research then that's your right, and if you're really concerned about it then I suggest taking it up with the experts.

How do you disagree? If we do the math, HSV-1 sheds 9-18% of the year, and this makes it 6 times more likely for it to spread through oral to genital sex than through genital-to-genital sex at 3% shedding rate. It's pretty obvious to me that one is more likely to get it through oral-to-genital sex. Obviously, oral HSV-1 is more common; 60-80% of adults, and once you have it, you're extremely unlikely to get it in another location. I've heard of couples where one has oral HSV-1 and the other doesn't and the other never contracts it orally during long relationships despite the shedding rate being much higher for oral HSV-1 than for genital HSV-1. Asymptomatic shedding or genital HSV-1 is also rare; most of that 3% shedding rate comes from OBs.

Only around 10-15% of us will make it out of life without acquiring HSV-1, so that's what makes it different from HSV-2. With HSV-2, 20% of adults have it, and it doesn't reach that twenty percentile until 40+ year olds, so it's not nearly as widespread in society. HSV-2 peaks at 20% while HSV-1 peaks at 85-90% by the end of life. With HSV-1, once you have it orally or genitally, you're not going to get it again in another location or you're highly resistant to it. Genital HSV-1 is more mild, recurs 10 times less than HSV-2, has a much lower shedding rate (MUCH LOWER RISK OF TRANSMISSION), and most of the population has HSV-1 so they're protected from getting it elsewhere on the body, which prevents those with genital HSV-1 to feel limited to dating only 20% of the population because the rate of HSV-1 is 60-80%.

"I'm also not sure that something shedding 1/4 of the amount (thereby making it 1/4 as transmittable) is so significant a difference as to make it that much less of a concern than either oral-to-genital HSV-1 transfer, or genital-to-genital HSV-2 transfer." ---I don't understand this point.

Herpes is herpes is herpes is not true. There are so many different factors; shedding rate, OB frequency, mildness, different prevalence of each type in society (HSV-1 is 4x more common than HSV-2).

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osten

I think we are running in circles here. I've told you many times, I am aware that shedding is more frequent in oral HSV-1 than genital HSV-1, and that that is a factor in making oral-to-genital transfer more common than genital-to-genital. I'm simply saying that the fact there are many more oral sources to begin with also has a profound affect on that statistic, and so for somebody who already has a genital infection, and is thus already a potential genital source, we must temper our interpretation of that 10% statistic with that knowledge.

I'm not sure what relevance it is that HSV-1 is more common than HSV-2. That has no bearing on it's medical significance. The rate of HSV-1 in the United States is 60%, and genital herpes is around 17%. Precisely where between those two numbers does HSV-2 because something serious, and HSV-1 not? Incidently, it breaks the 20th percentile in the 30-39 range. Still, I'm not sure what bearing that has at all. Both are very common, one less so than the other, but still very common. It doesn't change how serious or not serious the two are.

Of course factors such as the location and strain affect the potential strength of an infection, but an oral HSV-1 infection and an HSV-2 infection are not significantly different in terms of mildness. Both are usually very mild or asymptomatic, and on occasion can cause physical problems. Both roughly shed approximately the same amount.

Genital HSV-1 is of course more mild, but it sheds approximately 1/4 the amount of time as genital HSV-2. You can shout in capital letters about how this is a "much lower" risk of transmission, but we don't even need to use qualitative words like that. It's not much lower. It's approximately a quarter lower. On average, it should then take around four times longer in a given sero-discordant relationship to pass genital HSV-1 as opposed to genital HSV-2. Again, if you think this difference is is significant, well, all the power to you. However, I don't think it is as significant as you make it out to be.

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victor
I think we are running in circles here. I've told you many times, I am aware that shedding is more frequent in oral HSV-1 than genital HSV-1, and that that is a factor in making oral-to-genital transfer more common than genital-to-genital. I'm simply saying that the fact there are many more oral sources to begin with also has a profound affect on that statistic, and so for somebody who already has a genital infection, and is thus already a potential genital source, we must temper our interpretation of that 10% statistic with that knowledge.

I'm not sure what relevance it is that HSV-1 is more common than HSV-2. That has no bearing on it's medical significance. The rate of HSV-1 in the United States is 60%, and genital herpes is around 17%. Precisely where between those two numbers does HSV-2 because something serious, and HSV-1 not? Incidently, it breaks the 20th percentile in the 30-39 range. Still, I'm not sure what bearing that has at all. Both are very common, one less so than the other, but still very common. It doesn't change how serious or not serious the two are.

Of course factors such as the location and strain affect the potential strength of an infection, but an oral HSV-1 infection and an HSV-2 infection are not significantly different in terms of mildness. Both are usually very mild or asymptomatic, and on occasion can cause physical problems. Both roughly shed approximately the same amount.

Genital HSV-1 is of course more mild, but it sheds approximately 1/4 the amount of time as genital HSV-2. You can shout in capital letters about how this is a "much lower" risk of transmission, but we don't even need to use qualitative words like that. It's not much lower. It's approximately a quarter lower. On average, it should then take around four times longer in a given sero-discordant relationship to pass genital HSV-1 as opposed to genital HSV-2. Again, if you think this difference is is significant, well, all the power to you. However, I don't think it is as significant as you make it out to be.

Obviously, the infection rate of oral HSV-1 is much higher than genital HSV-1, and that makes them highly resistant or immune to a genital HSV-1 infection. If a person is negative for HSV-1, and has a partner with oral HSV-1 then it is likely that they will become infected as well. From what I've read, the transmission risk of genital HSV-1 to even a person who's negative for HSV-1 is very, very low due to it's low shedding rate. Does it happen? Of course it does, but not a lot. I don't make the stats up; I get them from sources, and I don't understand why you're taking offense to genital HSV-1 shedding less than HSV-2. I brought up HSV-1 and HSV-2 to acknowledge the low infection genital-to-genital rate of HSV-1 due to widespread oral HSV-1 infections. If you want to keep challenging the research then be my guest. I'm not making anything out to be more or less significant; I'm just stating the facts on shedding rates, transmission, OB frequency, etc. which I can't control, so no need to start putting words in my mouth or get upset. It's not my fault the research is what it is and that the experts think how they think. The obvious truth is that either type can be transmitted to either location from a one time encounter. HSV-1 sheds 3-5% of days while HSV-2 sheds 15-30% of days; HSV-1 doesn't shed a quarter less like you pointed out. And no, it wouldn't take four times as long to pass HSV-1 to a partner because herpes, as you know, is active when no symptoms are present. What I have read about HSV-1 is that it rarely sheds outside of an outbreak. It seems like you're a little stuck on your own thoughts that isn't supported my facts or research, and I'd rather not keep repeating myself with the facts presented. Genital-to-genital HSV-1 happens, but it's rare from what we know.

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RealisticGal
I do have another question. How can you tell if its HSV1 or HSV2? Will the blood test show that?

Yes, IgG-based HSV blood (antibody) tests can tell you if you have HSV-I or HSV-II or both.

I had a culture done bc I had one sore near my rectum and the office called and said it was positive for HSV they didn't say 1 or 2.

Culture tests can also reveal what type it is, but the doctor has to specifically order the lab to "type" the culture.

I didn't have a blood test. Do I need to ask her to do one? I am meeting with my doctor to talk with her further about this on Monday. Can u give me some ideas on what I need to discuss with her. I'm a little confused about the blood test being negative and three months later being positive?

Since the culture test that was done recently was, apparently, not "typed," the only way to try to figure out what type(s) of HSV you have is by way of the blood testing.

My theory is this:

  • You got genital HSV-I years ago from the partner with the cold sore.

  • You recently got HSV-II from your current partner, which would mean he has HSV-II.

  • The only way to know what he has is for him to get tested (TYPE SPECIFIC IgG-BASED Herpes Simplex antibody tests for BOTH HSV-I and HSV-II).

My rationale for this theory:

  • Your previous infection (HSV-I) caused only one mild outbreak.

  • Your recent outbreak was much more severe. This suggests it was caused by HSV-II, which typically causes worse symptoms in the genital area than HSV-I does.

  • It is less likely, but not at all impossible, to get genital HSV-II on top of HSV-I.

I'm a little confused about the blood test being negative and three months later being positive?

This is not unusual. In fact, it is one factor that can help us pin down the time frame of infection a little bit.

  • A culture test will come up positive immediately after a person has been infected.

  • Blood tests will not give positive results until such time as the immune system has formed enough antibodies to be detected by the blood tests.

  • Forming detectable levels of antibodies varies from one person to another. It can take as little as a week for some people, to as much as 6 months for others. The median time is 21 days for HSV-II and 25 days for HSV-I (based on a study by the U. of Washingon's Virology Department).

Hope this helps a bit.

:wavey:

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justlivingwithit

I don't know if your test came back or not, but something similar happened to me. I got genital HSV1 about 10 years ago with a bad primary infection. Several years later I started dating a new guy and we had a lot of sex. It caused another really bad outbreak, actually worse than the first! I was worried I caught 2, but turns out the sex just reactivated the virus from 1. So that could be the case with you. I've read that catching genital 2 if you already have 1 doesn't cause flu-like symptoms. It causes a few blisters that last awhile though for the first time.

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