HSV 2 Reference Range & Transmission

[GulfThirty]

I just received my WB results and it’s positive for HSV 2 negative for HSV 1. My questions pertain to reference range values and transmission but I’ll give you the back story.

I was in a monogamous but very sexually active relationship, without the use of condoms, for about 6 months when I noticed signs of a first ever herpes outbreak. This was 6/8/15. Started with tingling then I noticed red bumps that eventually blistered and scabbed over. The effected area was minimal and localized. 3-4 blisters on the right side of my penis where the base and scrotum meet in the follicular area and 2 more on the scrotum itself. Nothing on the shaft or head. On 6/20/15 I had an 8 panel STD test done which all came back negative including IgG HSV 1 & 2 with values of <0.90.

I was obviously relieved but nonetheless saw a urologist seeking answers to what the outbreak could be. He suggested it probably wasn’t herpes because of the minimal coverage and location of the sores, but wanted to do a second IgG for good measure. That was done on 6/20/15 and the results were positive with a 2.55 value. In disbelief I had a third IgG test done on 8/14/15 which came back positive with a value of 2.15. In October I had a second outbreak even less severe than the first with 2 red bumps that came and went within a week. Although still not convinced, especially after reading about the inaccuracies of these serological tests and low positives in the 1-3.5 range I opted to take the WB, which again was positive. No value given.

So here I am, all evidence pointing to HSV 2 positive and I’m looking for some guidance on how to move forward. My questions are, is there any correlation between the initial minor outbreaks/low reference ranges and the severity/frequency of reoccurrence? Do the low reference ranges statistically reduce the chances of transmitting to future partners either through asymptomatic shedding or during an outbreak?

Thanks for all you do.

[Terri Warren]

First, I think it is absolutely clear that have HSV 2 and the first presentation was likely your first infection. The index value has nothing to do with recurrence rates or asymptomatic shedding. Some people just have a low positive value and because you likely have new infection, that index value might rise but it doesn’t really matter anyway. You really won’t know what your recurrence pattern is going to be like until you live with this for a while. And remember that the first year of outbreaks is not likely to be representative of the future – you may have more in the first year as your immune system gets acquainted with the virus.

I also wonder if you might actually have HSV 1 but the test missed it. It misses one out of four. The reason is wonder if the minimal first infection – people who have HSV 1 are far less likely to be symptomatic with the first infection or have minimal outbreaks due to the presence of HSV 1. I could sure be wrong about this, but just wondering….

Terri

[GulfThirty]

You’d know better than I on the HSV 1. However, I’ve never had symptoms and surely one of the four tests would’ve detected it, right… is WB not the “gold standard” for HSV 1 as it is for 2?

I’d like to ask you more about shedding and sexual contact. Do those with either zero or intermittent outbreaks shed at a lesser frequency than individuals with constant outbreaks?

Is there a measurable percentage on how much shedding or transmission decreases overtime, say every year? Outbreaks are easy… don’t have sex. But the shedding is tricky because you’ll never know.

Also what’re your thoughts on claims about homeopathic antiviral supplements for herpes suppression such as olive leaf extract, oil of oregano, coconut oil? I know first hand the beneficial role that diet, nutrition, and natural supplementation can play in combating sickness and disease as I had issues with IBS and fatigue in the past. As I’m sure you know there’s tons of material out there claiming the above mentioned can be helpful in herpes suppression but it all seems grassroots… I haven’t stumbled across any concrete medical evidence.

Cheers

[Terri Warren]

Yes, the western blot, if negative for HSV 1, is correct.
Yes people who have no outbreaks shed less than those with outbreaks.
I’m very skeptical about these supplements, honestly. You asked.

Terri

[GulfThirty]

Hi Terri,

Thank you for you responses above.

So I probably should’ve addressed this in my first post, but I had made some assumptions that have recently turned out to be false. So, the girlfriend I was seeing at the time of my initial outbreak was also tested a few weeks after I was and the results were negative. We continued seeing each other for about a month or so but eventually split up for reasons unrelated to this. I never did see her test results but had no reason to think that she was being deceitful, so I took her word for it. However, after I became more informed about testing accuracy and seroconversion time I arrived at the same conclusion you did in your initial response which was this must’ve been a new infection, meaning it came from her. Again, I hadn’t slept with anyone else prior for at least 6-7 months so if I contracted before we started having sex my first IgG should’ve been positive. At that point there were a number of scenarios going through my head. She didn’t get tested out of fear, she forgot to specifically ask for a herpes panel so her GYNO didn’t order one, or she had been unfaithful got tested but hadn’t reached seroconversion. Either way we were done and it wasn’t going to change my positive status.

Well, I couldn’t leave it alone. I needed proof, so I reached out to her recently and requested a copy of the results and they are indeed negative. Assuming she didn’t sleep with anyone else while we were together (I have no reason to believe she did). What’re the odds that one of our IgG tests didn’t pick up the virus?

Again, my only two outbreaks were minimal and on the scrotum, it’s clear now that we both had negative first results, and I’ve seen in some of your other posts that even with the WB an unrelated protein can trigger positive results. I know it’s slim to none, but is there any other explanation of a similar looking genital outbreak or anything else that could be going on?

[GulfThirty]

Sorry Terri,

Now that I’m spitballing there’s another detail that might be useful I forgot to mention above. My ex does has a history of cold sores on her mouth. I witnessed one while we were dating. She performed unprotected oral on me many times.

I know both IgG and WB are designed to distinguish between HSV 1 and 2. I can’t remember if it accurately makes the same distinction when it’s a genital infection caused by an oral one.

Anyway figured that might be necessary to know.

Thanks

[Terri Warren]

So if you had not had sex for 6-7 months prior to your first outbreak, then the question is when was her last sexual contact before you and how long was it from that contact to the testing? If it was less than 4 months, her test may have been done too soon and result in a false negative. If that isn’t the case, then could she have had a new partner while having sex with you? If neither is the case, then the IgG missed infection in one of the two of you, which is not at all common for HSV 2.
If you have HSV 2 first, then you will almost certainly not acquire HSV 1 subsequently.
I doubt that whether the thing on your scrotum was herpes or not is relevant as you are testing positive for HSV 2 on the western blot, which means you are indeed infected with HSV 2.
Terri

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