December 29, 2018 at 8:30 pm #28989
Back in July of this year I had rough and unprotected intercourse (genital and oral) with a new partner. The same day I noticed a small cut on my penis, which I assumed resulted from the intercourse. Over the course of the next week, I experienced what seemed to be an initial genital herpes outbreak (sores on penis, fever, extremely sore thighs/buttocks). I went to a doctor that had me get on a two week dose of Valtrex after telling me that my penile sores were definitely herpes. I also got tested for all STD’s. The Valtrex proved to be very effective, and the sores were gone within a week. My results came back and I tested negative for everything, but the herpes test was an Igm so after doing some research I knew that I would need to wait and get an Igg test.I also had my partner at that time get tested and it turns out she came back positive for HSV1 and negative for HSV2 (not sure of her index scores, we do not speak anymore). She told me that she has never had an outbreak, but turns out her ex of three years had oral HSV1 and never told her. Over the course of the next 5 months, I would end up having 4 more genital outbreaks, the latest one after having a cold. I only used Valtrex (two pills of 500 mg a day) during active outbreaks. Before getting on Valtrex during my latest outbreak, I decided to take an Igg test (5 months after initial outbreak, 5 weeks after prior outbreak). My test came back as follows: HSV1 index: .1; HSV2 index: 1.24. I am confused as to how HSV2 is positive and HSV1 negative when the partner I am sure I got it from is HSV1 positive and HSV2 negative and never had an outbreak? I really thought I had genital HSV1. I am bummed out because I know that HSV2 is a lot more contagious. Is there any chance that it could still be GHSV1 and not GHSV2 since my 1.24 Igg index is so low after 5 months? Should I get another Igg or Western Blot to confirm or do my symptoms (5 outbreaks within July 1st and Dec 24th) signify HSV2? Thank you.
January 2, 2019 at 3:46 pm #29056
Yes, it is still possible that you have HSV 1 and that your HSV 2 IgG is a false positive. Your symptoms are more consistent with HSV 2 than HSV 1 but whether these were actually outbreaks is something I cannot be certain about. How much Valtrex do you think you’ve taken altogether?
I am definitely going to recommend that you get a western blot and be prepared for the results to possibly be the exact opposite of the IgG result since your HSV 2 is so low and the test misses 30%$ of HSV 1 infections.
January 2, 2019 at 9:41 pm #29063
I have requested the Western Blot from the University of Washington, they will send some stuff for me to give to my doctor and then I will mail the sample. To give you more insight, here is my outbreak schedule and how much Valtrex I have taken.
1st/initial outbreak: July 1st to July 20th (20 days), took 2 pills of 500mg Valtrex for two weeks. Total of 28 pills (2 daily for 14 days).
2nd outbreak: August 15th-24th (9 days), got a refill on Valtrex and used 500mg twice daily for about 7 days.
3rd outbreak: October 23rd-29th (6 days), used the remainder of the Valtrex from the second refill; 500mg twice daily for about 7 days.
4th outbreak: November 11th-22nd (12 days), got a refill on Valtrex and used 500mg twice daily for about 8 days.
5th outbreak:December 25th-January 2nd (9 days), used the remainder of the Valtrex from the second refill; 500mg twice daily for about 6 days. I got a terrible cold right before/during this outbreak.
Total Valtrex used within July 1st and December 31st (6 months): 84 pills (original prescription of 500mg x 28 pills taken twice daily during active outbreaks, plus two refills).
How long should I wait to take the WB to ensure the latest dose of Valtrex (I took my last pill today) I have taken does not affect my antibody levels and skew my WB results? 2-3 more months?
January 6, 2019 at 6:50 am #29107
It’s difficult to say with any huge certainty but I would say you should wait at least two months from now to do the blot. But if you get another outbreak, be absolutely certain to have a swab test done AND typed.
January 21, 2019 at 5:47 pm #29572
Well, I did end up having another outbreak and decided to go get a PCR test. I was swabbed on my penile sore and the results came back as:
In Range HSV1-DNA: Negative
Out of Range HSV2-DNA: Positive A. (Abnormal-applies to non-numeric results).
“Positive for Herpes simplex virus type-2. Typing was confirmed by monoclonal antibody microscopic immunofluorescence.”
Deep down I am still confused as to how this is so because my last partner was negative for type 2 but positive for type 1. Also my Igg was so low I was really hoping it was a false positive. Should I bother taking the western blott in a few months or should I just accept it is type 2 and move on?
January 29, 2019 at 11:25 am #29911
No, you do not need to take the blot.
Either you were infected prior to this partner OR the partner tested too soon after possible infection from someone else OR your IgG missed your infection which happens about 8% of the time OR your partner is lying about their results.
The positive typed swab test is sufficient for an accurate diagnosis.
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