HSV-2 Next Steps?

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Test Results (8/8/22)
HSV 1/2 IGG,TYPE SPECIFIC AB HERPESELECT QUEST ONLY:

HSV 1 IGG, TYPE SPECIFIC AB <0.90 (index)
HSV 2 IGG, TYPE SPECIFIC AB 1.19 (index)

HSV 1/2 AB (IGM), IFA w/Reflex to Titer (Quest OG):

HSV 1 IGM SCREEN: Negative
HSV 2 IGM SCREEN: Negative

Sexual History:
5/28/22: Protected Sex, Unprotected Oral Sex
7/31/22: Protected Sex, Unprotected Oral Sex
8/5/22: Protected Sex, Unprotected Oral Sex

Additional Context:
I don’t think I’ve had any obvious symptoms, just tons of worrying and stress maybe slight itchiness/tingling (perhaps bc I’m ultra focused on it). Also have some redness on the bottom of my penis but pretty positive it’s unrelated and is just balanitis/yeast infection that I’ve been treating after seeing a urologist but thought I would include that here. I did notice a tiny lump on my shaft that’s been here for about 9 days now. No redness around it, no irritation (maybe Folliculitis or an ingrown hair? The urologist did not seem worried about it). I just asked for an STI test and my doc ordered the following above tests in addition to other STI tests (HIV 1/2 ANTIGEN/ANTIBODY,FOURTH GENERATION W/RFL QUEST ONLY, RPR (DX) W/REFL TITER AND CONFIRMATORY TESTING(QUEST ONLY), HEPATITIS C ANTIBODY QUEST ONLY,CHLAMYDIA/N. GONORRHOEAE RNA, TMA QUEST ONLY). Everything else came back negative/non-reactive.

Questions/Next Steps:
Do you have any thoughts on next best steps? Should I re-test or do you think this is likely a false positive ?

Thank You:
Thanks again for your ebook as well as your public forum and all the other information you put out! It’s been immensely helpful as I’ve been diving down the rabbit hole.

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Just to be clear on the relevant sexual history:

5/28/22: I received oral sex from a female.
7/31/22 and 8/5/22: I received oral sex from a female and also gave oral sex to her (mouth to vagina). I am not aware of their STI history.

Thanks again.

[Terri Warren]

Your index on the HSV 2 IgG was very low indeed and probably has a 90% chance of being a false positive. Oral sex is not a real risk for transmission of HSV 2 from mouth to genitals. If you want to be more certain that this is a false positive, you should do the herpes western blot from the University of Washington

Terri

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Ok thank you very much for the reply.

If the HSV-2 is indeed a true positive, would it have to or rather is it very likely that is due to the result of a new infection ? Or is it possible for one to register this low and still have been infected for quite some time ?

The reason that I am asking is that the 2 interactions I describe above both involved protected sex and unprotected oral sex. I have in the past had unprotected sex but the nearest time was more than 10 months from the testing date.

Also, would it not make sense to take another HSV-2 IGG to achieve a higher level of certainty that this is indeed a false positive? For example, if I elect to pursue another HSV-2 IGG and results are in a similar range 1.1 – 1.3, or even a negative, can I be fairly certain that this is a false positive?

Again, sorry for all the hypotheticals. I’m just thinking of of achieving a high level of certainty without taking the western blot.

Of course, if it’s highly recommended or you recommend it in my case, then I can go ahead with the western blot.

thanks again.

[Terri Warren]

I have seen true positives at 1.15. So I’m not going to say that another low positive puts you in the clear. If you want to know if you have HSV 2, get the western blot. You can work with your own provider and UW to get this or you can work with me. Or you can skip it. I suggest you get it done.

Terri

• This reply was modified 5 months, 1 week ago by Terri Warren.

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Update. I tested the IgG again, this time with Labcorp on 10/19/22.

Quick Recap:

All My Test Results (8/8/22):

HSV 1/2 IGG,TYPE SPECIFIC AB HERPESELECT QUEST ONLY:

HSV 1 IGG, TYPE SPECIFIC AB <0.90 (index)
HSV 2 IGG, TYPE SPECIFIC AB 1.19 (index)

HSV 1/2 AB (IGM), IFA w/Reflex to Titer (Quest OG):

HSV 1 IGM SCREEN: Negative
HSV 2 IGM SCREEN: Negative

Test Results (10/19/22):

HSV 1 and 2-Spec Ab, IgG w/Rfx

HSV 1 IgG, Type Spec <0.91

HSV 2 IgG, Type Spec 1.07

HSV-2 IgG Supplemental Test Negative

Relevant Sexual History –

5/28/22 : Protected Sex, Unprotected Oral Sex
7/31/22: Protected Sex, Received and gave unprotected Oral Sex Unprotected Oral Sex
8/5/22: Protected Sex, Received and gave unprotected Oral Sex

Note: 7/31/22 and 8/5/22 were the same partner. I am male, and all my partners have been female. I’ve only ever participated in vaginal sex.

Further Notes:
I’m first generation, both of my parents immigrated from India. I’ve had unprotected sex twice in my life. Once in 2018 and once again about 12 months ago (different partners).

Would you still suggest I proceed with the western blot or do you think it would be safe to just move on? Again, I don’t think I’ve had any symptoms other than just lots of worrying and freaking out over slight itching, tingling, etc.

Thank you again for all your help.

[Terri Warren]

I do not think you need the western blot, no. You’ve moved into the equivocal range on the test and your sexual history does not suggest that you are at high risk for acquiring HSV 2. If you can let this go, do it, if you cannot, get the blot. I don’t believe that you are infected.

Terri

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