HSV1 IGG Result and Time of Exposure

[doqq08]

Hello – I’m mid-30s male in a long-term monogamous relationship for 8+ years. I recently had an STI panel done as I had not had one for about 5-6 years. My doctor told me it’s good to periodically test. I asked to include everything.

My HSV-1 IGG result came back as 21.4 High. My assumption is that figure ruled out false positive. My HSV-2 result was <0.90 and normal so I believe that means negative. The medical provider indicated it was not an active infection (though not entirely sure what that means). I have no history of cold sores (that I know of) or genital lesions/blisters. I currently am feeling like my genital region is tingling, but I’m not sure if that is just my anxiety making me believe I am experiencing symptoms. My test results came back only a couple days ago. My partner will be testing to confirm her status so I can’t speak to that yet, but I don’t believe she’s ever shown any physical symptoms. Labs were done through Quest Diagnostics. Lab report says “Herpes Simplex Virus 1/2 (IgG) (HerpeSelect) with Reflect to HSV-2 Inhibition (Final Results).

My partner I have have regular sexual activity, primarily with condoms. Occasionally there will be oral sex usually performed by me, but I have also received it with no condom use. Occasionally we will begin vaginal sex with no condom then switch after a few minutes, however, this is rare. I’d like to try to understand the IGG result a bit more and understand my risk of transmission.

Questions:
Is it possible for me to have been exposed many years ago with the IGG index result that I received and not have transmitted it to be my partner?

If that is possible, would it be uncommon for me not to transmit HSV-1 to my partner if her IGG lab test comes back negative?

[Terri Warren]

It is definitely possible that you were infected orally in childhood and have just not had symptoms. Or you could be infected genitally and not be symptomatic. HSV 1 genital infection is rarely transmitted through intercourse so I wouldn’t be too concerned about transmitting to a partner if she tests negative. The IgG test also misses 30% of HSV 1 infections so not trustworthy. About half the population between 14 and 49 in the US has HSV 1 infection. However, the CDC is very clear that HSV should NOT be included in STI screens due to the high rate of false positives. Your HSV 1 result is NOT a false positive, bTW

Terri

[doqq08]

Thank you for the response.

I had very little knowledge of HSV-1 or -2 before my antibody test. I realize there is a massive stigma that comes with it. I have sort of a two-part question:

Is there anyway to know whether I have oral or genital HSV-1 other an outbreak or assumptions that many exposed to oral HSV-1 during childhood considering I have no recollection of cold sores?

If my understanding that oral HSV-1 is more contagious is correct, would it be reasonably to assume that I likely have genital HSv-1 if my long-term partner tests negative for HSV-1 based on GSV-1 study shedding rates and lower transmission rates compared to oral HSV-1?

(I think I did questions/profile right but let me know if I didn’t)

[Terri Warren]

There is no way to know, without an outbreak in either location, whether your HSV 1 is oral or genital, correct. Oral HSV 1 is more contagious, correct.
I don’t think you should assume that this is genital, no. I’m not sure how you came to that honestly.

Terri

[doqq08]

Thanks again! Reasoning was based on my understanding that genital HSV-1 sheds at a very low rate after 2 years (I think I saw study that said about 4 days a year on average?), so if I have not transmitted this to my partner I was thinking that could be a reason since I always thought oral herpes was easier to transmit.

Last follow up: do people with no symptoms or symptoms that are very mild they may go unnoticed benefit from anti-viral suppressive therapy? I read that many doctors do not like to prescribe daily anti-virals for people that have no noticeable outbreaks.

• This reply was modified 1 month ago by doqq08.

[Terri Warren]

That’s a good question. Biologically, the result should be the same for people without or without symptoms but shedding in asymptomatic people who taken antivirals has not specifically been studied.

Oral herpes does shed more than genital HSV 1 so it is easier to transmit

If I had a partner who was truly negative for HSV 1 and I was positive for HSV 1, even without symptoms, and transmission was a concern, I would take daily antiviral medication

Terri

[doqq08]

I think I may have 1 or 2 additional follow up questions. Just have 1 more that I thought of. Recently, I’ve noticed some sensations in my boxer region. Outside thighs. Sometimes I have dry skin so this may be related to that. Since my positive IGG, I’ve been extremely aware of any sensation that feels abnormal in my facial region and lower half. It could be something unrelated that I’ve simply never really noticed also. Still no recollection of any physical outbreak either orally or genitally. I have read some studies about how shedding rates are studied and it seems like over a period of days participants swab areas to see if they are shedding the virus.

Question:
Is there any at-home kit that I could try to determine if I’m shedding the virus from a particular region? I understand it could be expensive, but not sure if this is even a thing for at-home usage.

[Terri Warren]

Yes, there is a website that allows you to purchase an HSV PCR swab and do swabbing at home. There is probably more than one, but I only know about this one. It is 247labkit.com This would allow you to swab at home if you have concerning symptoms or skin changes.

Terri

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