Primary Herpes 34 weeks pregnant

[Kayle T]

Hi Terri,
my situation is quite complicated and I’m really struggling to shed some light here. I’m also in Europe, so the Western blot or even swabs are unfortunately not an option for me here. Also the whole herpes topic is very poorly understood, or should I say mostly ignored.
So here it goes: been together with my husband for more than 19 years now, we are monogamous. He has a past history in HSV1, with occasional mild oral outbreaks, not in the last couple of years though. His IGG level is 18.

Me:
January 2015
HSV 1+2 IGG: 1.3 positive
I than had 3 pregnancies, 2 C-sections and one vaginal birth in between, no problems.

November 2022
HSV 1+2 IGG: 0.5 negative
HSV 1+2 IGM: negative

Never head any symptoms until the end of this April, when 34 weeks pregnant:
23 April bump on my labia, thought it was from the razor
25 April itchiness, stinging, two more small bumps appeared
Some itchiness, than pain, two small bumps that looked like pimples, I didn’t know it could pe herpes, I looked online but I saw the crops of vesicles and I didn’t think it could be it
28 April bumps were already healing, but after reading some more online I started panicking. Went to the doctor (infectious diseases specialist) and to the lab – only test available was antibody tests:

28 April 2023
HSV 1+2 IGG: 0.7 neg
HSV 1+2 IGM: 6 pos
Doctor said likely herpes, but the bumps were healing and also they were small, slightly painful, no scabs.

02 May:
HSV 1 IGG (4 days after first test, different lab): 10 positive
HSV 1 IGM: 0.6 negative
HSV 2 IGG: 0.07 negative
HSV 2 IGM: 0.8 negative

13 May:
HSV 1 IGG: 9.43 positive
HSV 1 IGM: 0.6 negative
HSV 2 IGG 0.08 negative
HSV 2 IGM: 0.8 negative

I am now 38 weeks, extremely worried of transmitting this to my baby, as neonatal herpes is so devastating. Based on my antibody results it looks like a primary infections But I had 0 sexual contact with my husband since finding out I was pregnant (no oral either).
I really need some insight and advice

[Terri Warren]

Well, this could be a new infection, that’s true. Also, the IgG for HSV 1 misses 30% of infections, so it could be that as well – the initial tests missed it and this one picked it up. If you’ve had no sexual contact with him since you got pregnant, including him giving you oral sex, then this is certainly not new genital HSV 1. True primary infections would show up on an antibody test within a few months of being infected. You could have new oral infection but you could have also had false negatives in the past. You are definitely positive for HSV 1 – the question is where – have you never had a cold sore in your lifetime? Has your husband given you oral sex in the past? If yes, it could be genital, but would not be new infection since you’ve not had sex since your pregnancy began. You should discuss this with your OB provider. Have you never had genital sores?

Also, you are getting very different results from these two labs. I think an index value of 10 is not a false positive.

Terri

• This reply was modified 1 week, 6 days ago by Terri Warren.

[Author]

Posts