Concerned About HSV2

[jm1022]

My question is concerning HSV2 test results. A few weeks my SO developed a cold sore on her mouth so knowing that I’ve engaged in sexual activity with others in the past I decided to get tested. The last time I was tested was October 2020 and all my labs were negative, including HSV2. The new test taken on Feb 5 came back as equivocal with a 0.93 reading. I waited 5 days and re-took the test and it came back equivocal at 1.07. I contract STDCheck.com to do my labs so they use the standard CPL/LabCorp herpes IGG tests. You said in previous forums that you’ve rarely seen HSV2 on the mouth so I’m confused as to why my SO would have a cold sore in her mouth when I’m negative for HSV1 and possible infected with HSV2. I’m going to wait 2 weeks and re-test to see where the number is heading but I suspect I’ll be in the positive range by then.

Does any of this make any sense?

[Terri Warren]

First of all, the IgG test misses 30% of HSV 1 so you could well have HSV 1 and the test missed it.
Your partner may well be having a recurrence, not a new infection.
Your HSV 2 values are not positive and likely do not represent an infection.
Has your partner had any new partners, do you think? Was any swab testing done from her cold sore?

Terri

[jm1022]

Hi Terri. Thank you for your response. My partner has never had a cold sore in 22 years that I’ve been with her. I don’t think my partner has had new partners but I’ve had a new partner for a year now and switched to unprotected sex in December 2020. We’ve engaged in unprotected sex about 3 times since December with the last time on January 17. My recent labs with equivocal results are from Feb 4 and Feb 8. My last labs in October showed HSV2 and HSV1 were both negative. My new partners tells me that she’s only had protected sex with others and I’m the only one that she has had unprotected sex with.

[Terri Warren]

So first of all, are we certain what she had on her lip was a cold sore? That would be the first question to sort out. Was it swab tested, and if positive, was it typed?
The second thing, as I said, is that the IgG test misses 30% of HSV 1 infections so you could be infected and not test positive on the IgG test.
The next possibility is that your other partner has HSV 1 and you contracted it recently and are not yet antibody positive but transmitted it to your partner with the cold sore.
Your HSV 2 is interesting but without knowing the timing of your sexual encounter with the other partner and her testing status, I can’t help much with where that HSV 2 index value is going, if anywhere.

Terri

[jm1022]

Thanks Terri. I’m not sure if what my partner had was a cold sore. It looked like a cluster of blisters on the edge of her lip and it healed within 2 weeks. She didn’t want to go to the doctor so it wasn’t swab tested. I had 3 sexual encounters with my other partner between Dec 8 and Jan 17, the last one on Jan 17. She claims she’s always tested negative for HSV2. I’ve always tested negative for HSV2 so having 2 equivocals in a row and with the indicator increasing from 0.93 to 1.07 I’m definitely concerned. I’ll probably repeat the labs again in 2 weeks so I can be at the 6 week mark since the last encounter.

[Terri Warren]

The presentation sounds exactly like herpes to me
Did your other partner know her HSV 1 results?
If your partner with the cold sores had done an antibody test right away, it would have possibly been helpful in knowing if her HSV 1 infection is old or new.

Terri

[jm1022]

Hi Terri, I just bought an additional set of questions. Would HSV2 cause her blisters on her lip? Would HSV1 be causing my HSV2 labs to present as equivocal while HSV1 shows up negative (even though I may be positive but I’m in the 30% of positives that the test misses)?

[Terri Warren]

While HSV 2 could cause blisters on her lip, that is not common at all. If you have HSV 1 and the test missed it, there could be some cross-reactivity with that and the HSV 2 test, looking it to be reactive when it really isn’t. That’s correct.

Terri

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