Herpetic whitlow and vaginal discharge

[Kelly1]

Hi Terri,

I had my first and only genital herpes outbreak almost seven months ago. It was swab typed HSV2 however, I have been blood tested 3 times since then and they are all negative for HSV2 and positive for HSV1. My OBGYN said that the typing had to have been wrong on the swab because I’m not on any suppressive therapy and it would show in my LabCorp IgG blood test for sure by now. My most recent blood test was two weeks ago. Anyways, going off of that I have to believe it’s type1 down there. Never had blisters anywhere else.

Here are my questions:

1. Is HSV found in vaginal secretions/discharge regardless of lesions being present or not?

2. Do I need to be concerned about the possibility of herpetic whitlow if I’m masterbating or washing myself in the shower?

3. The other day I was masterbating and had vaginal secretions on my finger. I later realized I had a torn cuticle on that finger. I did wash my hands about 20 minutes after masterbating with soap. I didn’t notice any kind of genital outbreak. However, my OCD is worrying me that I could possibly transfer the herpes to my hand because of the torn cuticle. Is that something I should be worried about?

4. Does the term viral shedding mean that the virus is flaking off like how dry skin does or is it just at the virus is active at the surface of the skin?

5. Would the answers to my questions be the same regardless of whether or not I have HSV1 or HSV2 down there? (Just curious…)

Thanks for your help in better understanding these things.

[Terri Warren]

1. Is HSV found in vaginal secretions/discharge regardless of lesions being present or not?

It can be because it can be sloughed off from your cells and find its way into secretions

2. Do I need to be concerned about the possibility of herpetic whitlow if I’m masterbating or washing myself in the shower?
No, not after seven months

3. The other day I was masterbating and had vaginal secretions on my finger. I later realized I had a torn cuticle on that finger. I did wash my hands about 20 minutes after masterbating with soap. I didn’t notice any kind of genital outbreak. However, my OCD is worrying me that I could possibly transfer the herpes to my hand because of the torn cuticle. Is that something I should be worried about?

It isn’t OCD, its a normal concern, but I think extremely low risk because your infection is now well established.

4. Does the term viral shedding mean that the virus is flaking off like how dry skin does or is it just at the virus is active at the surface of the skin?

On the surface of the skin

5. Would the answers to my questions be the same regardless of whether or not I have HSV1 or HSV2 down there? (Just curious…)

Yes,

Now I think you need to sort out the question of if you have HSV 1 or HSV 2 because that is very important. You could do a herpes western blot, have you thought about doing that?

Terri

[Kelly1]

Terri,

I hadn’t considered a Western Blot yet because as I said previously, my first and only genital outbreak was almost seven months ago. However, the one time that I was with someone that could have possibly exposed me to HSV2 was a little over a year ago. He never claimed he had herpes but I never saw a test from him either. Due to it being a whole year, I think this is why my doctor said the HSV2 would definitely show by now. She said that the LapCorp tests are very sensitive to HSV2. Two years ago I tested positive for HSV1 but never had any blisters or symptoms to show for it.

Does a LapCorp test that shows 4.02 for HSV1 for sure a high enough number to be positive?
I’m curious because after my first outbreak when I was re-tested that number jumped to like 28.2. I was thinking maybe the 4.02 could have shown exposure to the virus but not actually infection because of the big gap difference in the numbers and not having any actual symptoms.

I read that IgG misses 3 out of 100 infections. Now does that mean it will miss a persons infection indefinitely?
I’ve taken (3) different tests and HSV1 clearly shows and HSV2 is negative, not even a low result. Can you please clarify if this means that an infection can be detected on a re-test or do 3% of the people being IgG blood tested just never show infection?
I hope you’re understanding my question.

Thanks again for your help!

[Terri Warren]

It sounds to me like you had two different brands of antibody tests with one being 48 and the other being in the 4.02 range. If the IgG screening test is going to miss the HSV 2 antibody it will miss it every time, in my experience. Is that what you are asking?

You have certainly waited long enough to get a western blot, yes, for greatest accuracy.

Terri

[Kelly1]

Hi Terri,

Yes, thank you very much, that was what I was asking. I believe this is my last post.

Do you know what the actual procedure is to determine the “typing” after a swab test comes back positive?

(I’m interested in the accuracy of the “typing” process)

Also, in the upcoming weeks I will be interested in having the Western Blot test sent to a nearby Quest. That is $250 total for the test and draw?

Do you believe the Western blot is just as accurate as a swab test, and that I can be certain one way or another when the test comes back?

Thanks again!

[Terri Warren]

The typing is a separate process from the viral identification if culture was used and a one step process of PCR is used. I’m not clear about the exact chemistry of how the test works, honestly. But I’m sure you can look it up online. I’ve asked our lab if the typing can be mistaken and they say no, but I believe I have seen it once or twice in my career.

As for the western blot – it looks for antibody and the swab test looks for actual virus – different test completely. The western blot is most always a yes or no for the two types but every now and then, it will give an indeterminate result which means it can’t be sorted out completely.

The cost is $250 in 45 of the 50 states, $315 in five states – FL, NY, PN, RI and MD.

Yes, this was your final test. If you have more questions, feel free to renew as needed.

Best,
Terri

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