January 10, 2024 at 4:38 pm #83869
I am a heterosexual male.
In 2014 I had a surprise outbreak of sores at the base of my shaft. I was in a monogamous relationship for 4 months at the time, sexually active without condoms. Within a few days I had the sores looked at and swabbed by a medical clinic, and I was told it was positive for herpes. I don’t recall whether the clinician stated HSV1 or HSV2 because I wasn’t in tune to the difference back then, and I don’t recall the exact procedure/protocol used other than they used a swab.
Fast forward to December 2019, where I had learned a lot more about this virus. I got a Herpes IGG test at a Quest Lab (out of curiosity) and the results came back at:
HSV 1 IGG 6.99 HIGH
HSV 2 IGG <0.90 NORMAL
My conclusion was that my past outbreaks (relatively rare) were HSV1 outbreaks in the genital area.
Fast forward to the SEP/OCT 2023. Had unprotected intercourse with 2 different women. Shortly after that sexual activity, I had what I thought were recurrent genital outbreaks (like 1 per month, which was a lot for me), and just assumed they were HSV1 outbreaks. But-it seemed a bit painful to urinate and, on one breakout, my lymph nodes in my pelvis were a bit extra swollen. Didn’t seem totally right, so I got tested DEC 2023 with the following results from Clinical Pathology Laboratories:
HSV 1 IGG – 4.520 H
HSV 2 IGG – 43.50 H
HSV2 was obviously a surprise and seems way out of line for any number I’ve ever seen on this forum, so I got retested 4 weeks later at Quest Labs with the following results:
HSV 1 IGG – 5.30 H
HSV 2 IGG – 7.32 H
Much lower HSV2 number, but still clearly High range.
The Quest lab sent me a note that stated they wanted me to come in for an HSV2 Confirmation Test.
Is the confirmation test advised? Should I get a Western blot? Or did HSV2 sneak in after an established case of HSV1? Really hoping I don’t have HSV2.
January 12, 2024 at 11:31 am #83890
I don’t think the confirmation test is necessary. The frequency of your new recurrences monthly, the high HSV 2 results at ClinPath and the subsequent relatively high IgG at Quest would be adequate, in my opinion, to establish that you now have HSV 1 and HSV 2 genital infection.
In addition, we are seeing more and more false positive inhibition assays (their confirmatory test), as compared to negative western blot results.
I think it’s time to believe that you also have HSV 2 and possibly recommend that your two partners be tested for HSV 2. You may also wish to consider daily antiviral medication to reduce the risk of transmission by 48% as well as condom use that reduces transmission by 96% from men to women
January 14, 2024 at 11:59 am #83941
Thank you for the perspective an advice. So in your mind, there is absolutely no reason to take Western Blot? Sounds like you don’t think I have false positives on the IGG?
I’ve done some research on IGG levels changing over time, basically looking at graphs of the IGG level in the y-axis and time in the X-axis. I saw one graph for Covid and one for Herpes. Is my understanding correct in that the IGG levels take a period of weeks (not months) to gradually ramp up from initial infection to their highest level, and then drop down a little bit (not much, but a little) and stay stable there for the long haul?
And then do the IGG levels spike back up on a subsequent outbreak? Is that maybe why I had a 43.5 IGG HSV2? Or was it high because of an initial GHSV2 infection?
I’m just trying to understand the timing of my initial GHSV2 infection, considering I had a 43.5 IGG in December and a 7.32 IGG just 4 weeks later. I read that IGG test assays are a qualitative analysis and not a quantitative, but these numbers have to leave some clues. I’m just trying to figure out approximate timing of GHSV2 infection. What would you guess on timing?
Then, based on what we think is timing of initial GHSV2 infection, how long does it take to have a robust and mature antibody response? The reason I ask – am I far enough along on my natural immune response to GSHV2 (based on my lab work and timing above) to start taking Valtrex on the daily? Or should I wait? (I know I need to wait on the Valtrex if I’m doing a Western Blot). I am not sexually active currently.
Is there any information that those of us with both GHSV1 and GSHV2 should know, as compared to someone who just has only one type in the genital region? Any good news on having both in the same area, or is it just an extra dose of bad?
Last question – what is the latest on research for treatment vaccines for those of us already infected?
Thank you so much.
January 22, 2024 at 2:32 pm #83973
You are comparing apples and oranges here. I don’t believe that the two labs use the same IgG test kit at all, so the ranges would be very different. Which in your case, they are.
I think if you wish to go on suppressive therapy at this point, it’s fine.
If you only had the quest IgG score alone, I would encourage the blot but with the ClinPath value being so high, i doubt a false positive. But if you want to do the blot to be extra certain, I’m fine with helping you get it.
Your HSV 2 will recur far more often than your HSV 1 genitally.
If I were you and had both genitally, I would go on daily suppression prior to becoming sexually active, no question about it.
There is a lot of very promising stuff going on with treatment vaccines and gene editing right now!
January 24, 2024 at 1:39 pm #83989
Thank you. Understood on apples/oranges. Didn’t realize that.
I will think about the Western Blot. If so, what are the pre-requisites/preparations for the test? Meds, sexual activity, fasting, etc?
Based on my account above of sexual activity, symptoms, and lab test values/dates….Is there any guidance you can give me on probable timing of the GHSV2 initial infection? Can you say with decent probability that I got it last half of 2023? First half? Prior to 2023? Many years ago?
Would further IGG testing over time help you answer this question with greater confidence?
On another post – I saw you answer another question about timing by saying “you could tell your client when they DID NOT get infected”. So maybe I ask you the question that way instead. Just any deductive guesswork on timing would be so helpful for me. I fully understand that it’s just guesswork and there’s no way to know for sure.
Last question – I’ve talked to some people who recommend the Mylan generic form of Valtrex because it is white and doesn’t have the blue dye that some people are sensitive to. Do you feel that the Mylan generic product is equal to the dark blue pills in terms of preventing transmission?
Look forward to your answers.
January 25, 2024 at 4:02 pm #84014
There are no prerequisites for taking the blot
It isn’t possible to know when you were infected, I’m afraid. But it was sometime between 2019 and your test that was positive the first time.
Further IgG testing would not help with determining that.
If you are sensitive to blue dye, then a white pill would clearly be preferrable. Few people are sensitive to that dye, but maybe you are.
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