GHSV1 After Having HSV2/Swab Typing

[M85]

Hello,
So I was contacted by an ex girlfriend yesterday that I haven’t been with for THREE YEARS. She told me that she just tested positive for HSV2 on a blood test at her gyn. She is young and conservative. She told me that she has only been with me and one other guy. She is asking me to go for a blood test, which I intend to do.

That being said, I contracted GHSV1 from a different girl about a year after she and I broke up. I had a very mild initial outbreak and nothing ever since. Just a few painless spots basically. I had a swab test done that confirmed positive for GHSV1, negative for HSV2.

So my question is, is it possible that I already had HSV2 and later contracted GHSV1? From what I’ve read, this seems unlikely. Also, is it possible that the swab test only identified the HSV1 because I was currently having an HSV1 outbreak, but would still show up negative for HSV2? I have never had a blood test for herpes, but I have had a lot of partners and was pretty reckless sometimes in my younger years. I haven’t had any symptoms of anything or any STD testing done within the last two years, since that initial GHSV1 outbreak. Thank you for your help!

[Terri Warren]

No. If you get HSV 2, there is something like a 1 in 50,000 chance that would get HSV 1 subsequently. It is also very possible that you didn’t get HSV 1 from the different girl if your first outbreak was a year after you broke up. You could have had it since childhood!
The swab test would only pick up virus that was present, that’s correct But it is highly unlikely that you would have HSV 2 orally.

In regards to your previous partner who is positive for HSV 2. it is important for her to know that if her index value for HSV 2 is below 3.5, she needs a confirmatory test. There are many false positives in the range of 1.1 to 3.5

Terri

• This reply was modified 1 year, 8 months ago by Terri Warren.

[M85]

Hi Teri,
A few things. First, I think there was a typo in your initial response. “No. If you get HSV 2, there is something like a 1 in 50,000 chance that would get HSV 2 subsequently.” I believe you meant to say that it’s a 1 in 50,000 chance to get HSV ONE subsequently. Is that correct?

Secondly, I believe you misunderstood my explanation of my initial and only outbreak. My apologies, I will try to clarify. I had a very mild genital outbreak, not an oral one, that was swabbed and came back as positive for HSV1, negative for HSV2. As far as I know, I never had HSV1 as a child, but I could be wrong. Makes sense though, given that my HSV1 outbreak was genital, not oral. Right?

This was a year after I broke up with the first partner, (who has now tested positive for HSV2 years later) and right after sex with the second partner, leading me to believe that I obtained HSV1 from the second partner. I was hoping the fact that I had a genital outbreak of type ONE a year after breaking up with my first partner, would likely imply that I did not previously have HSV TWO when I was dating the first partner.

I was able to get my blood drawn yesterday and I’m waiting on results from the IGG test. I will follow up with my past partner on her results.

Thank you!

[Terri Warren]

Yes, that was a typo, sorry.
Thanks for clarifying your situation.
Now I get it. When we get your blood results back, we’ll know if you have HSV 2 at all. The thing is, if you had your first outbreak one year after last having sex with the person who tested positive for HSV 2 later, do you know if this person also had HSV 1? If you have ever had other partners in your life prior to that, the HSV 1 could have come from anyone prior to that OR the first partner if they also have HSV 1 OR the new partner (do you know their HSV status?)

If this was new HSV 1 infection from the newest partner, then that definitely suggests that you did not have HSV 2 when you acquired HSV 1.

Let me know your IgG results, OK?

Terri

[M85]

Terri,
Oh, this has taken a strange shift. I got my IgG blood test results back today and I came up as being negative for BOTH types!! So I previously tested positive for HSV1, negative for HSV2 on a swab test from my genitals two years ago. A false positive from a swab test seems very unlikely based on what I’ve read. Also, a false negative on an IgG test seems unlikely with an infection that would have been established years ago at this point. So I am quite confused.

I had this recent blood test done at urgent care and their only answer was to follow up with my primary care doctor. I don’t really have one and I’m sure their answer will just be to do another blood test or just, “Huh…that’s weird.” I’m considering having the Western Blot test now. What do you make of this?

[M85]

Also, I did not receive an index value for this recent IgG test. It just says negative for both types.

[M85]

Oh, I spoke too soon. The results were just uploaded to my patient profile. As for the index value it just says <0.90 which I know is equal to a negative result, but they did put a number on there.

[Terri Warren]

the IgG test for HSV 1 misses 30% of infections, when compared to the gold standard western blot – that’s 1/3! A very high miss-rate. If you had a positive swab test for HSV 1, you should definitely believe that result over the IgG result.

Terri

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