Genital HSV1 and HSV2?

[Lunabean2023]

Hi Terri,

In February of 2020 I was diagnosed with GHSV1. I lived for 3.5 years with no symptoms. On August 8, 2023 I had a possible exposure to HSV2 (which I’m absolutely terrified of getting). I had IGG blood work done at 4 and 6 weeks that was negative (<0.2).

At 7.5 weeks after possible exposure, I noticed some symptoms. Doctor confirmed via PCR swab it was an outbreak of type 1 (my first flare up ever.) My blood work at this time was still negative for HSV2. On October 5 I started taking Valtrex 2x a day and the lesions went away by about October 10th/11th. On October 13, however, I noticed a new possible lesion. By October 15th it was gone, but I did go to the doctor for another blood test and culture on Oct. 13th. The blood work for type 2 (9 weeks after exposure) was negative (<0.2). I’m still waiting on the swab test and absolutely losing my mind with anxiety.

Which gets to my questions:
1. Could this new lesion from Oct. 13 have been an initial outbreak of type 2? It seems odd that the first type 1 lesions would have healed completely then a new one came. Or is it more likely that it was just another type 1 lesion?

2. Is my blood work from Oct. 13 after 8 days of Valtrex accurate, or would the antivirals have impacted it?

3. If the culture from the 13th is positive for type 2, is that 100% accurate?

4. If the culture from the 13th is negative, when can I rule out type 2? I was on Valtrex for 10 days total (October 5-14th). Would this impact my 12 week IGG blood work? If so, how much longer do I need to wait?

5. When can I do a Western blot test given the concerns about antivirals? Does having HSV1 also mean I need to wait longer to Western blot test because of delayed antibodies?

I also have an anxiety disorder and this is the 7th circle of hell. I tried to schedule a virtual visit but the next available isn’t until November. Is there any chance we can talk this week? I’m absolutely desperate.

Thank you so much.

[Lunabean2023]

Following up a few days later here… really desperate for guidance 🙁

[Lunabean2023]

Oh I forgot to mention that right after the possible exposure I took Valtrex for two weeks. So the timeline again:

Aug 8: possible exposure

Aug 8-22: taking Valtrex

Sept. 5: negative IGG

Sept. 19: negative IGG

Oct. 1: negative IGG

Oct. 5-14 taking Valtrex

Oct. 8: negative IGG

With the two windows of taking Valtrex, can these IGG results be trusted?

I also got the swab test back that I mentioned above and it was negative for HSV2.

Thank you very much for your help.

[Lunabean2023]

Hello… this was posted a week and a half ago. Does anyone know when a response will be received? Thank you.

[Terri Warren]

When you keep posting new thing, it moves your question down the line. And yes, the next appointment is in November as I am in India, working now. Will be home in November.

1. Could this new lesion from Oct. 13 have been an initial outbreak of type 2? It seems odd that the first type 1 lesions would have healed completely then a new one came. Or is it more likely that it was just another type 1 lesion?
I think it is more likely an outbreak of HSV 1 – wasn’t that confirmed by your doctor with a swab test?

2. Is my blood work from Oct. 13 after 8 days of Valtrex accurate, or would the antivirals have impacted it?
It is unlikely that 8 days of Valtrex would impact an antibody test.

3. If the culture from the 13th is positive for type 2, is that 100% accurate?
yes, but I thought you said it was negative? Now I’m really confused

4. If the culture from the 13th is negative, when can I rule out type 2? I was on Valtrex for 10 days total (October 5-14th). Would this impact my 12 week IGG blood work? If so, how much longer do I need to wait?
See the answer above. I swab test taken right away with a symptom that is negative is likely correct.

Terri

5. When can I do a Western blot test given the concerns about antivirals? Does having HSV1 also mean I need to wait longer to Western blot test because of delayed antibodies?

[Lunabean2023]

Hi Terri,

There was an update I posted since asking the initial question. The timeline regarding my concern for contracting GHSV2 is below:

Aug 8: possible exposure

Aug 8-22: taking Valtrex

Sept. 5: negative IGG

Sept. 19: negative IGG

Oct. 1: negative IGG

Oct. 5-14 taking Valtrex

Oct. 8: negative IGG

Oct. 13: negative IGG

So to sum up, it’s been 11 weeks from my possible exposure. During those 11 weeks, I was on Valtrex for a total of 24 days.

Follow up questions:
1. Given I was on Valtrex for 24 days, can any of the blood test results outlined above be trusted?
2. Given Valtrex, would my 12 week IGG next week be accurate or do I need to wait longer?

And my 5th question from the initial post wasn’t answered:

5. When can I do a Western blot test given the concerns about antivirals? Does having HSV1 also mean I need to wait longer to Western blot test because of delayed antibodies?

Thank you.

[Terri Warren]

Follow up questions:
1. Given I was on Valtrex for 24 days, can any of the blood test results outlined above be trusted?
That’s a bit long. If you do the blot, I would recommend waiting 14 weeks rather than 12 weeks. And I would say the same for the IgG if you decide to repeat that.
2. Given Valtrex, would my 12 week IGG next week be accurate or do I need to wait longer?

And my 5th question from the initial post wasn’t answered:

5. When can I do a Western blot test given the concerns about antivirals? Does having HSV1 also mean I need to wait longer to Western blot test because of delayed antibodies?
I recommend above that you wait 14 weeks and no more antivirals until you test unless you have an outbreak that has been confirmed as positive and typed. That will cover any concern about HSV 1 impacting the result as well,though that is covered in the 12 week period

Terri

[Lunabean2023]

Thanks Terri.

My blood work on October 1 that was 5 weeks post exposure and 5 weeks off Valtrex was negative.

On October 5 I started Valtrex again and my blood work on October 8 that was 6 weeks post exposure was negative as well.

I read on another question that you said if your IGG is negative at 6 weeks it’s 70% likely you weren’t infected. Does that apply to me here? I’m going to repeat IGG and do blot at 14 weeks but desperate to have any good signs to cling onto that chances are I wasn’t infected.

Many thanks.

[Lunabean2023]

Oh forgot to mention- all the blood work mentioned above was a low negative of <0.2 if that impacts your opinion at all. Thank you!

[Lunabean2023]

Also this just in today: after being off Valtrex for a total of 8 weeks since possible exposure, blood work from yesterday for HSV2 was negative again at <.02.

So at 5, 6, and 8 weeks I had <.02 HSV IGG levels. If I had been infected, would this level has risen at least a little by now? I plan on retesting and doing blot per your earlier recommendation as well.

[Terri Warren]

yes, if your IgG is negative at 6 weeks out, there is a 70% chance it will be negative altogether. And I do think if you were infected, your numbers would be rising, correct.

Terri

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