HSV 2 positive, partner negative

[CAJJ]

Hi Terri,
This will require some background information so here goes. I have been in a relationship/married to the same person who is my only sexual intercourse partner for 16 years. Prior to this I did have oral sex and genital to genital contact with another person. Six months ago my husband informed me he had sex with another woman 3 times during the past 4 months prior to this confession. Their last encounter occurred 6 months ago. After this came out, we found out she tested positive for HSV 2. She had never been tested previously and did not know of her status. My husband was then tested at 12 weeks from their last encounter and tested negative with the ELISA IGG test coming back in the negative range of <.90. He was tested again at 22 weeks post exposure to confirm and again tested negative with <.90 with the ELISA IGG test. I decided to have a full STD panel done just to be safe and wish I had not! I tested negative for everything except HSV 2. My ELISA IGG came back at 3.75. I have never had outbreak symptoms. Of course after finding out about my husband’s infidelity and his partner’s HSV 2 status, I felt like I had burning and tingling in my buttock region. I had small pinpoint bumps there but I shave there as well. With his negative results I had no further symptoms or feelings except those bumps which I believe was razor burn. When I tested positive I began having burning and tingling in my buttock region again with no change as far as bumps or lesions go. I guess my question here would be does it sound like I have had this infection throughout our entire relationship? I believe my husband is truly negative with these results and no symptoms I just think it is crazy that I never transmitted it to him through 16 years of sex! We are considering having another child. I know the risk of transmission is higher in pregnancy with a “new” infection. With his negative status is it safe to assume I do not have a “new” infection but a very well established one?

[Terri Warren]

So let me be certain I fully understand your situation.
Prior to having sex with your husband, in your whole life, you had not had intercourse with anyone else? Or did the genital to genital contact involved intercourse?
The screening test does miss about 2 out of 100 cases of HSV 2 compared to the best test, western blot.
Also, there are some false positives o the test. Your index value of 3.75 is just over the cutoff of what we would normally confirm. This results just isn’t making much sense. Either the screening test missed his HSV 2 positive OR your have a false positive screening test OR perhaps I misunderstood your sexual history? I would recommend a western blot for you for confirmation.

Terri

[CAJJ]

You understood correctly. In my entire life I have only had one sexual partner. The genital contact I referenced did not involve sexual intercourse. My husband had also only had one partner prior to his infidelity. Should my husband wait a few more months and test again or should I proceed with the Western Blot? I guess I am just wondering with my history, if my husband tests negative can I just let it go and assume it is a false positive? Honesty we would not do antivirals because we have no symptoms. If I did have the Western Blot through your clinic, do you know approximately how much it would cost? I live in Georgia.
Thank you for your help.

[Terri Warren]

Well, if you wouldn’t do antiviral therapy you still need to know if you have herpes for another pregnancy, right? The cost is $250 through our clinic. So your ELISA is positive – what are you going to do, assume you are positive and take antiviral therapy at the end of a pregnancy? I’m just not sure what you would do with this value that just doesn’t fit with your experiences.

[CAJJ]

I did consider just taking antivirals during the last 4 weeks of pregnancy and assuming I was positive, though I would rather not take unnecessary medications. Would I be able to call your clinic at any time to have the test set up? I ask because I was thinking about waiting until after the holidays for financial reasons! Thanks!

[Terri Warren]

You know, either of those options would be OK – testing with western blot or just treating during the last month of pregnancy, of course, you would need to work with your OB Provider on that one. Just treating would be far less costly for sure and I think quite a reasonable option.

You can always contact the office and we an arrange a test at any point, no worries there.
What, you would rather spend your money on holiday gifts than find out if you have herpes or not? haha just kidding, who wouldn’t! This can wait.
Best
Terri

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