Low HSV2 positive, WB ?

[unkayak]

Hello Terri,
Started a new relationship in Feb, partner and I both coming from monogamous long-term relationships followed by long periods of abstinence ( 1+ yrs ). Neither of us have ever had any S/S of genital or oral HSV, although neither of us were specifically tested for HSV 1 or 2.

In May my partner decided to get a full STD work up after an abnormal PAP showed HPV. Her Herpeselect IGg values were:
HSV1 – 1.70 and HSV2 – 2.63. I was tested in June and my Herpeselect IGg values were: HSV1 – 22.70 and HSV2 – 0.13.

We had been planning on attempting to get her results verified via WB eventually ( She is a breast cancer survivor and had other issues that were more pressing at the time). Recently however, she has developed a small painful spot in her perineal area that is red and irritated. Unfortunately her OB/GYN is out of town until the end of the month so a swab is out of the question for the time being. With the appearance of potential symptoms I am worried that I passed my HSV1 to her genitally via Oral, although as I mentioned I cannot recall ever even having a classic cold sore.

Questions:

In your opinion would it be worth getting the WB done to rule out a false positive for HSV2 and/or confirm HSV1 ?

Is my result of 22.70 for HSV1 unusually high ?

Is there any way to get a WB test done considering we live in NY ?

Thanks in advance for your time

[Terri Warren]

I would strongly suggest that she go to an urgent care clinic to have the red area swab tested, if possible.
It would definitely be worthwhile getting a western blot to clarify both her HSV 1 and HSV 2 tests because both fall into the low positive range.
I’m wondering if you were drawn at different labs? Your test results look like they might be from LabCorp but perhaps not her? I think your HSV 1 is consistent with a well established HSV 1 infection – nothing especially high. Have you had cold sores in the past?
Yes, we can arrange for a western blot for you. We are conducting a research study for people who live in the five states that do not allow routine shipments to UW and because it is a research study, the blood can legally be shipped. There is a charge for this but it can be arranged for you pretty easily.
If she does have HSV 2, she will not get your HSV 1 not will she get it if she already has HSV 1.
Please let us know if we can help.

Terri

Terri

[unkayak]

Thanks Terri, we were tested at different labs, my test was done at Shiel labs and hers was from Quest.

My test = HerpeSelect 1 & 2 ELISA IgG reflex to HSV2 Inhibition study
Her test = hsv 1 igg ab herpeselect
Looking at the result pages they both show the same ranges for negative /equivocal etc (<0.90 , 0.90-1.10) so guessing same tests ?

I will pass on the advice to go to urgent care for a swab. Is it part of the swab test to distinguish between HSV 1 or 2, or will we need to request that as something extra ?

How do we start the process of getting her a WB from your clinic ?

I figure I got HSV1 orally as a kid. I can’t recall ever having a cold sore, but other siblings definitely do . I do have oral Lichen Planus that very occasionally pops up, but not in the last few years…usually responds to 1 dose of topical steroid cream.

If her infection does turn out to be genital HSV1, and I have it orally, am I right in understanding that it would be very unlikely for me to then get it genitally?

Thanks again for your time

[Terri Warren]

The swab test, if requested by the clinician, can definitely type the virus yes
I don’t love the inhibition assay, but did that actually happen, that it was reflexed to that test?
If she has HSV 1 genitally then yes, you are extremely unlikely to acquire it genitally since you have it orally.
You just call the clinic for an appointment to order the western blot.

Terri

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