Confused by test results: IGG HSV-2 Positive Viral Culture HSV-1 Positive

[KITTYCAT77]

I have had the same partner for 5 months. In Feburary we both got tested for std (had no idea herpes is not a standard test didnt think to ask for one) were negative and deceided to no longer use condoms. We had unprotected sex in March as well. When I saw him May 1st we had sex again and what followed 3 days later was the most painful outbreak imagineable in my vagina and inner labia. My Dr says due to the severity , the worst pain I’ve felt in my life, she is convinced it is new infection. She said that my HSV-1 genital is from oral sex but I am confused how I got it because my partner and I did not even have oral sex in May. Only coital. Could it be he has genital HSV-1? Why did I not catch it until months later, Is it possible that becuase I was recovering from strep throat that my immune system was low and I caught it then instead of the months preceding? I don’t understand why I have never seen any type of bump or rash anywhere on him, mouth or genital.

I am also confused with the test result. I had IGG , IGM and Viral Culture by swab. Test results below. What’s confusing to me is that I tested positive for HSV-1 by viral culture but negative to HSV-2. On my IGG test, I tested positive for HSV-2 but equiviqol for HSV-1. What exactly do I have? Is the HSV2 old and the HSV1 new? Do I need to tell future partners that I have both strands and can infect them both HSV-1 and HSV-2 gential ?

HSV 1 IgG, Type Spec 0.00 – 0.90 index <0.91
HSV 2 IgG, Type Spec 0.00 – 0.90 index 1.50

HSV, IgM I/II Combination 0.00 – 0.90 Ratio 1.39

Culture- Positive for Herpes simplex virus type-1. Typing was confirmed by
monoclonal antibody microscopic immunofluorescence.

• This topic was modified 7 years, 8 months ago by KITTYCAT77.

[Terri Warren]

OK, here is what I think is going on. If the swab test typing is actually correct, It is likely that the HSV 2 is a false positive. It is in the low positive range, and at your index value, there is an 85% chance this is a false positive. The HSV 1 antibody test may be negative because either 1) this is brand new infection and you’ve not had a chance to make antibody yet or 2) this is an established infection and the antibody test missed which, and this happens all the time. Please ignore the IgM test – it is unreliable enough to be ignored.

While the most common way to acquire HSV 1 by receiving oral sex, it is also possible to acquire it through intercourse. And because HSV 1 genital infection is infrequently active, it would make sense that you would not have been infected earlier. So yes, he could have HSV 1 genitally and have infected you in this way.

I believe that what you need is a herpes western blot when four months have passed since this outbreak. This test is far more sensitive for HSV 1 than the screening test and will clear up the question of whether you have HSV 2 or not. We can order this for you at a Quest lab near where you live.

Please let me know other questions that you might have.

Terri

[KITTYCAT77]

Thank you very much for your insight. My doctor wants me to come back in for an IGG type specific test in 6 months but I will prefer to ask for the western blot and if they are not able to do it then I will call your company to order it at Quest Lab for me. I am assuming that I do not need my Dr then if I choose to have you order the test for me?

I have been wondering about the transmission of this. Since I tested positive for HSV-1 genital is it a high probability that I could give it to someone to their mouth if they were to perform oral sex on me ? Or because it’s a genital virus it’s more likely to transmit through genital to genital contact. I have never had a herpes lesion on my mouth.

Sorry I have tried to do much research with different results on this and would appreciate your expert insight.

One last thing, I read that the first 6-12 months is when there is more active virus (likelihood it could shed and transmit). I would like to ask my Dr to give me a low dose of either 250 or 500 ml valtrex per day for the first 6 months at least. What do you think about that ? I am worried even with protected sex that I could potentially transmit it to a new partner since the condom only protects the penis area. (My previous partner did not take the news so well….) I can’t imagine having anyone else go through what I went through and want to make sure I am doing everything I can to keep transmission rate down.

[Terri Warren]

If you do have genital HSV 1, then it is unlikely that you would transmit this to someone’s mouth because it is shed infrequently from the genital tract. Correct. And also unlikely because so much of the population already has HSV 1 infection.

I wouldn’t start suppression quite yet if you want to do the western blot as a follow up test because the medication can impact your HSV test results. You only need to wait 4 months from the last possible sexual encounter to have that confirmatory test done and then you will have a clear and clean answer without the involvement of daily antiviral therapy to confuse the picture. You just have less than three months to go with that if I have the timing right.

Right, your doctor will likely not be able to order the herpes western blot through the usual lab routes. And I don’t see another IgG test being helpful in your situation.

Terri

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