Low positive HSV-2 results, yet partner got GHSV-1?

[Confused12]

Hi Terri,
Very confused and looking for insight. My questions are at the end.

August 7th- I had the first unprotected one night stand of my life. 7 months later still no symptoms.

August 12th- I had oral and vaginal sex with an ex girlfriend that I had been with exclusively for most of 2021. My ex contacts me saying she got herpes symptoms a few days after our sex. I get a blood test on august 22nd.

My HSV-1 IGG results were 39 (expected as I get 2-3 oral cold sores a year). However, my HSV-2 IGG results were a 1.24, positive by .15! My IGM was negative for both.

Her swab test then came back positive for GHSV-1, which unfortunately made sense but left me more confused about my HSV-2 results.

Doctors were no help, basically disregarding my results while refusing to give me another one. I was told that I should only consider myself to have genital herpes if and when I get an outbreak.

August to November- Many Doctor visits with no answers. I have irritation swabbed twice, both negative for herpes.

In December I start seeing someone new. I disclose that I get cold sores. In our only sexual encounter I gave her oral sex, and there was genital to genital contact but no sex. I get a cold sore the next day. She then has an outbreak and tests positive but did not specify which type and broke off communication.

Since the second incident, I swore off oral sex, and had two regular partners without issue. Currently, uncertainty and regret has stopped my sex life completely.

Now, I’m constantly flipping between being convinced I have genital herpes, Or deciding that it was two unfortunate cases of oral shedding.

1.) What is the likelihood I received asymptomatic HSV-2 from the one night stand?
2.) What are the odds that both of these transmissions were from oral sex? I know it is very rare, but it seems to be the case for my ex at least.
3.) Could my 39 score of HSV-1 explain a low positive HSV-2?
4.) Where could I get additional testing, and will it even help?

[Terri Warren]

1.) What is the likelihood I received asymptomatic HSV-2 from the one night stand?
Very unlikely. Also, if she got new HSV 1 infection from you, then she didn’t have HSV 2 because one does not acquire HSV 1 after having established HSV 2.

2.) What are the odds that both of these transmissions were from oral sex? I know it is very rare, but it seems to be the case for my ex at least.
I think likely!

3.) Could my 39 score of HSV-1 explain a low positive HSV-2?
Yes, there could be some false positive action going on here, due to cross reactivity with HSV 1

4.) Where could I get additional testing, and will it even help?
The CDC says you definitely need a confirmatory test as you have a very low positive. it is such a shame that your doctor was unaware of this guidance. You can work with the University of Washington and your own doctor to get this or you can work with me at westoverheights.com. There is statistically an 85% chance that your HSV 2 result is a false positive.

Terri

[Confused12]

Hi Terri,
Since my last question I received a second Herpes test which was positive as well with an increasing IGG.

Possible exposure was on 9/5/21…
3/14/22 Test Results: HSV 1/2 IGM: Negative
HSV-1 IGG: 43.50 (39 on 9/20/21)
HSV-2 IGG: 1.83 (1.24 on 9/20/21)

1.) I’ve seen that IGG tests are 90% accurate after 12 weeks, does that number still apply to a positive as low as mine?
2.) Although still low, does the fact that the HSV-2 number increased by .59 indicate that it is a true positive?
Regardless, I definitely want to get a Western Blot to confirm and was hoping to do so with you. How can I go about setting up a meeting?
Thanks.

[Terri Warren]

So sorry that I missed this follow-up question. You are still having a very low positive on your HSV two test and the increase is not significant. This may be occurring because you have such a high HSV-1 index value. To get a western blot with me as the ordering person, you would follow the link to get a western blot on this website. It would take you to an E visit where you would set up an appointment. After all this time, you may have already done this already. Again I’m sorry for missing this question. It appears that I missed about three questions posted on the same day about 10 days ago.
Terri

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