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Confused About Immune System Response to HSV

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Hi! I was just wondering if anyone can clarify a few questions I have about HSV and the immune system's response to it.


1. Do asymptomatic people or people with atypical/mild outbreaks generally have a stronger immune system?


2. The swollen lymph nodes and flu like symptoms common in primary/first outbreaks are proof that the immune system is hard at work and putting up a good fight, correct? From my understanding, this initial heightened response helps keep the virus in check later on. If that's the case, does that mean that people who have a bad typical first outbreak have a stronger immune system than people whose immune systems don't respond in that manner? Or does this just mean the person with the mild/atypical symptoms has such a strong immune system it didn't allow the virus to get to the point where a heightened response was needed in the first place?


I ask because I believe I was exposed to the virus and the pattern of my outbreaks seems strange. A few days after exposure (maybe 5) I had a slight sore throat and my body was a little sore in the morning, but I felt completely fine the next day (no swollen lymph nodes, no fever). About 2 days after that I was feeling raw at the entrance to my vagina and attributed it to the sex but decided to take a look downstairs. I noticed 2 teeny tiny pink breaks in the skin near my perineum/vaginal opening on the left side (only tender to the touch and I needed a mirror to see them since they were so inconspicuous) and clumpy white discharge typical of my past yeast infections. I didn't think much of it because it's not unusual for me to get yeast infections after sex with condoms and the sores looked like they were caused by sex. Yeast infection medicine from the store cleared all my symptoms up quickly and the sores were no longer raw by the 2nd or 3rd day and no longer visible by the 5th or 6th day. No itching during the whole episode.


It wasn't until I started feeling shooting pains throughout my body (mostly left leg, but also right leg and even the arms a few times) that I got concerned about herpes. These pains happened during/after the outbreak but not before. One day my left leg felt weak and it was hard to walk on it (but there was never pain to the touch). These pains went on for quite some time intermittedly.


About 26 days after the start of my first episode, I got the same breaks in skin in the same area except this time on the right side. Also had yeast infection symptoms which cleared up quickly with medication again. The sore healed quickly like the first time. Since the first episode happened the week before my period and this episode was also happening the week before my period I figured it may be just hormonal (but I couldn't figure out the ongoing leg pains so that scared me, but I figured it was psychological). I decided to wait another month before panicking to see if this would happen again. Again no itching at all during this episode.


Lo and behold, about 26 days after the start of the last episode (again the week before my period), I felt soreness on my labia when I wiped after the bathroom. I looked down and there were 2 clear blisters on the outside of my inner left labia. I popped them easily (stupid I know, but it felt better after and I washed my hands). I couldn't go to the Dr. since I was spending the weekend in nature (awful timing). The next morning, the blisters multiplied and there were a bunch of tinier ones all clumped together (hard to say how many total but maybe 8-10) and my lymph node in my throat was sore. The outbreak was't debilitating, but certainly uncomfortable and definitely worse than the first two episodes - I was still able to hike. No itching this time either. Day 3-4 were the most uncomfortable since the sores had burst and were rubbing against my pants. Day 5-6 sores were no longer open and not hurting.


Is the fact that my immune system didn't put up a strong/obvious response to the first minor episodes (or even the third for that matter) the reason why the later episode would be worse? Or does the fact that my first two episodes were minor mean that my immune system's response was strong? In other words, does minor outbreak = strong immune system? I read that the lymph nodes in the throat would only get swollen during a first outbreak - yet, mine definitely were swollen to coincide with the appearance of the blisters during my third episode.


I've had 3 outbreaks in 8 weeks - is this normal? Could this be one long primary episode?


I got tested for HSV about a year before this exposure and was negative for both HSV1 and HSV2 (blood test - never had any symptoms but requested it anyway). Assuming I didn't acquire HSV1 in the time period in between the test and these outbreaks (I definitely didn't acquire HSV2 prior to the exposure that started this because I hadn't been intimate with anyone), wouldn't the first episode have been much more severe? Or can people without antibodies to either have mild/atypical first outbreaks too?


The sexual encounter that sparked this was pretty low risk (condom used except for a second when he very quickly put the tip of his penis inside of me and immediately pulled it out. He didn't have any visible lesions or anything, but yes I know HSV can spread regardless and with condoms use). The oral sex he gave me may be more concerning since we didn't use protection for that. He didn't have any visible mouth lesions and I don't know his cold sore history, but he was battling a sore throat at the time. So if he does have oral HSV then I could see a higher possibility of transmission due to his lowered immune system at the time. I'm going to go get another blood test at the 12 week mark to see what i'm dealing with here. I am hoping it's HSV 1, but since I've already had 3 outbreaks in 8 weeks, I'm guessing that's unlikely since HSV 1 is supposed to come with less outbreak frequency. Thanks for your help!!






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While I can't answer the first two questions, you need to make sure that you are not triggering your outbreaks from your behaviors. It is possible that if you can control these things, your outbreak frequency may be reduced. The importance of avoiding these triggers cannot be overstated.


Here are some things to avoid that commonly trigger outbreaks:


Physical stress, such as fatigue

Emotional stress, such as depression, anxiety

Immune suppression (can be triggered by sickness, infection, steroidal medications or surgery)

Vigorous sex or friction to the skin during intercourse or masturbation

Irritation or excessive sweating around the genital due to tight pants or riding a bike

Excessive alcohol consumption

Exposure of affected area to strong sunlight or ultraviolet light


Also, make sure you do not consume foods high in arginine, such as:


Nuts: almonds, walnuts, cashews and peanuts

Grains: whole wheat, oats, brown rice and even flour products


Caffeinated liquids or beverages


Taking 1g of lysine daily may help counteract arginine, and help prevent outbreaks. During an outbreak, up to 2g-4g of lysine daily may be used.

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Hello Caligirl85,


Your questions are great & I've actually wondered how the immune system impacts the degree or severity of symptoms. I present in a way that I would consider atypical. I have never had an outbreak to my knowledge. I get mild itching & tingling (the tingling came about after discovering I had H) from time to time. I have lupus & I thought that my weakened immune system would cause me to have severe OBs.



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