Third IgG/IgM or Western Blot?

[fourtwenty]

Hi Terri, it’s a relief to find this site with great information. There’s so much to wade through with this disease.

I was recently diagnosed with HSV 1 & 2 via IGG with no indexing. My past experience is the following:

Partner 1: 3/2016 – 2/2018
She informed me she got cold sores sometimes, and it’s a risk I took after doing research on HSV1. She did not tell me of any HSV2 diagnosis, nor did she say she had symptoms over the course of our relationship.

Right before the relationship started, I was tested:
3/28/16
HERPES I AB IGG, SERUM (<0.9 Index) <0.2
HERPES II AB IGG, SERUM (<0.9 Index) <0.2
Interpretation Criteria:
Negative <0.9
Equivocal 0.9-1.0
Positive > or = 1.1

I spent 2 years on/off with this one partner. I’ve not had any symptoms of either HSV 1 or 2, and on occasions where she had a cold sore, she let me know when prodrome was happening and when she had an outbreak to avoid kissing her. She was also on antivirals.

Partner 2: 12/2017
Received oral sex with no condom. Spoke with them about HSV when I got the test below, and they said they were clean for both HSV 1&2.

2/8/18 – Mayo Clinic – Second test
HSV1 – Positive (No indexing)
HSV2 – Positive (No indexing)

Partner 3: 4/2018 – 5/23/2018
We kissed a lot before I disclosed my HSV diagnosis, I was afraid to tell her. I then find out she also has HSV1 after. I guess I’m no better. Is disclosure necessary? It’s beyond frustrating to navigate. She took it okay and said she does not have HSV2. We did have unprotected sex once before and after I disclosed and I let her know the 10% risk of transmission. We have since stopped seeing each other, and my last contact with her was 5/23/18. Considering this potentially recent known exposure to HSV1, should I do another IgG & IgM with indexing? I spoke with UW about the Western Blot and my doc is ready to order it. Should I wait some time? Or get it done now to hopefully give me a definitive answer? Since this is lifelong, I really need to know.

Thanks!

[Terri Warren]

It would be very helpful to have a test with an index value given to know best how to advise you. But given the circumstances of your encounters, I do think a western blot would make a lot of sense. Did the most recent partner have a negative HSV 2 test or did she just believe she did not have HSV 2? If it was just her opinion, I would recommend waiting 12 weeks from your last encounter with her to get the blot. If she actually has a negative test, I think you are fine to test now.
Terri

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