Do my results conclusively show I'm HSV2 positive?

[ccranium]

I had unprotected intercourse on Feb 6, 2015 with a woman who told me ahead of time she is positive for HSV 1 and 2. She had a hysterectomy in late November 2014 and was (she thought at on Feb 6) clear of recovery symptoms from that surgery. I turns out later that she was not and had a vaginal cyst which had not fully healed. She says none of her former partners over 25+ years have ever displayed symptoms, nor has she (she is on daily Valtrex for another non-STD condition).
I had a blood draw on May 13 which came back as Negative for HSV 1 Type Specific IgG and A Positive for HSV Type 2 Ab, IgG.
I had another draw on June 16 which came back as A Positive for HSV Type 2 Ab, IgG, Index 2.63, and a Western Blot which has comments stating no antibodies to Type 1 detected and “atypical reactivity noted against proteins on the HSV-2 Western Blot.” The WB test was performed by UW Virology.
I’ve never had any of the symptoms described in your book.
I’m a 55 y/o male with no other past partners of which I’m aware of having HSV 1 or 2. Only the one instance of intercourse with the Feb 6 partner. No intercourse, nor intimate contact with her, since that date.
Should I pursue more testing, or is this WB conclusive after 18+ weeks?

[Terri Warren]

The western blot is conclusive for HSV 1 but inconclusive for HSV 2. There is some protein detected that is similar to the one produced by HSV 2, but it could be a cellular protein of some kind and not herpes. It appears that you waited the four months suggested to get the western blot. However, now I think what you should do is redraw the blot in 6 months. The UW guidance on this suggests that if that test is also indeterminate, that you should consider yourself negative. I know that the indeterminate result is incredibly frustrating and we see it more and more with these low positive results, such as your 2.63. I actually think it is unlikely that you would contract herpes at one intercourse, but not impossible.

Terri

[ccranium]

Thank you.
When you suggest “6 months”, should I wait 6 months from the date of this latest test (until ~Dec 15, 2015) or until 6 months from the possible exposure (~Aug 6, 2015)?
My index in the May 13 test (~14 weeks) was 2.46. Is the increase to 2.63 in June (~18 weeks) relevant?
If the next Western Blot test is also positive, and the next Index is again similar and inconclusive, what test is possible to be conclusive one way or other. I still have had no visible symptoms.
With no visible symptoms and these inconclusive results at 6 months, should I still use condoms, seek an anti-viral prescription, and/or refrain from receiving oral sex from an uninfected partner?
Thanks again for your help. You’re a gift of a resource!

[Terri Warren]

The increase is not relevant.
I would advise waiting waiting a total of 10 months – 4 months from the last risky encounter and then 6 months past that but let me absolutely confirm with UW.
Generally, if you are still indeterminate then you should consider yourself negative.
I would not use antiviral therapy as that can confuse the test results but I would use condoms, yes. Just to be extra cautious, because I tend to function that way in these cases, I would tell a partner that your herpes test results are not clear at this point so you are going to be certain to use condoms and be extra careful.

Terri

[ccranium]

Thank you. I will not seek antiviral therapy until after the next WB is done with a new, convalescent specimen. The UW comments suggest testing the specimens together. Does that mean they will have some remaining specimen from my 6/16/15 draw and want to test it again alongside the next convalescent draw? I didn’t know the labs hung on to samples for that long, or at all…? Or is the “together” sample something else?

Did you hear back from UW about my earlier 6 month question (6 months from last possible exposure, or 6 months from the last test)? I can do either, or even both if there’s value in that…; just want to test as accurately as possible to get as much clarity on this before making lifelong treatment decisions, or not, and the risk or lack of to a future partner.

Thank you, again.

[Terri Warren]

Yes, they said 10 months. Running a convalescent sample (yes they keep the first one usually) always helps them but it is double the cost. If they run a second blot and just compare the two paper blots, that is also useful and cheaper.

Terri

[ccranium]

Hi again, Terri.

Following up on this thread, I had another draw on Nov 30 and the result comments from the UW Virology Lab are “Low level antibody detected by Western blot assay. Indeterminate for HSV.” and “No antibody to herpes simplex virus type 1 detected by Western Blot Assay. Atypical reactivity was noted against proteins on the HSV-2 Western Blot. This reactivity may or may not be due to HSV-specific antibody. …”

This time there is no result for the index value, at least in the report copy I got.

It’s been 42 weeks, 3 days since I had the potential exposure to HSV 2, and I have been and am still asymptomatic at all times. Asking my Internist if I’m likely positive or likely negative for HSV 2, they answer with “likely negative.”

Any thoughts from your experience would be greatly appreciated. Thanks!

[Terri Warren]

I would totally agree that if it has been 42 weeks since you had ANY possible exposure to HSV 2, then you should consider yourself negative. Remember that that means any sex with anyone whose HSV 2 status you do not know, not just the person you had sex with whose status you know is positive. Do you see what I mean here?

Terri

[ccranium]

Yes, I do understand. I’m in a very monogamous relationship and intend to be, but I’ll re-ask about their status just to be sure for both our sakes.

Thank you for all your help, advice, and responsiveness.

[Terri Warren]

You are most welcome.

Terri

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