Forum Replies Created
October 1, 2022 at 8:54 am in reply to: Can a Person Spread HSV-2 and Never Test Positive themselves? #78930
Is this your test results or your spouses test result?
If she has a negative IgG at this time and yours is a substantial positive, it is unlikely that she gave this to you, but not impossible. The IgG test misses 8% of HSV 2 infections compared to the western blot.
It isn’t possible to know what the tingling is about without doing a swab test of the lips when you have the tingling. But from the way you describe it, it’s pretty constant.
Also, the contact you had with your husband is not at all a risk for transmission
I also doubt very seriously that he is being tested for herpes in prison. That would be extremely unusual as the CDC doesn’t recommend testing unless someone has concerning symptoms.
It would be good to know more conclusively if he has HSV 1 by doing an antibody test at some point. About half the population has this so he may well be infected and not know it.
The vaseline scenario is also not a risk for transmission
It is so unnlikely that she would have a scratch on her back big enough to let virus in IF you happened to be shedding at the time. The skin of the back is very thick and this situation presented very close to zero risk of transmission. I wouldn’t worry about it if I were you.
there is no risk of getting HSV 2 from grinding with clothes on, no.
Touching a buttocks or thigh of an HSV 2 positive woman is not a risk for acquiring HSV 2.
Both of those things are risk free.
The risk from oral sex is HSV 1. You already have that and if you’ve had cold sores in the past, the risk of getting this in a new location is remote at best. And if you have HSV 1 genitally, you aren’t going to get it again. Since your partner is also positive for HSV 1, I think you guys are all set to go.
oh goodness, I’m so glad you got the information that you needed.
There is no greater risk with artificial insemination than with intercourse for your baby, no. Intrauterine herpes for a baby is highly unusual and I don’t think you should worry about that while trying to conceive.
For completely different reasons, I had a “turkey baster” baby 32 years ago. Last year I told her about it – she laughed and laughed.
- This reply was modified 1 day, 2 hours ago by Terri Warren.
1. Did this exposure pose a risk for infecting me with HSV2?
It did NOT
2. Due think my doctor is correct about herpes sores having blisters and would be very painful with an active OB?
Most people who contract herpes do have sores at some point and they are usually at least tender
3. I was previously negative to HSV1 & 2. Do you think I should test again after this?
4. If I have not shown symptoms since would I be over reacting that I am asymptomatic and shedding the virus?
Yes, I believe that would definitely be an over reaction
5. I am worried I will pass it to my partner and her or I will indirectly pass it to our children during bath time (washing them) or while helping them in the bathroom (wiping or potty training). Is this completely not a risk?
It is completely not a risk.
6. Can you clarify where men & women shed the virus asymptomaticlly without sores?
Men shed virus from the penis and anus, women shed from the labia, vagina and anus
I doubt that you have HSV 2. Urine PCR is not done in the US and I would be very unlikely to believe that you have HSV 2 with nothing on your IgG test. You could repeat the IgG once more to be more certain but your contact was not a risk and you symptoms sound more like folliculitis than herpes to me.
The IgM had a terrible record of false positives and the CDC in the US recommends against it’s use – ever.
1.) Should I see a urologist?
You could. Your symptoms just don’t sound like HSV 2 to me.
2.) Should I refrain from sex or anything for 3 months and test IGG again? or western blot?
You could start with the IgG test and see what you get. If negative,you should know that the IgG test misses 8% of HSV 2 compared to the western blot. In terms of sex with others, if you do have sex, you should use a condom.
3.) I guess another option is waiting another 2 weeks or so and then testing again or waiting to see if I have any reoccurring symptoms? I Just don’t know how to navigate this with not knowing a 100% what’s happening.
Understood, but by it’s nature, there is some ambiguity there.
4.) Is it possible I have HSV1 genitally too?
That is very unlikely given a long history of cold sores.
Condom protected oral sex does not present a risk for transmission if the condom covered the whole penis during the experience.
Symptoms of herpes would be sores in the genital area and they would normally appear between 2-10 days after infection. If you’ve had no symptoms in 10 days, and given the condom use, infection seems very unlikely to me.
I think your partner should be tested to see what type of herpes he has.
Daily antivirals reduce transmission by 48% and condoms reduce transmission by 96% from males to females. if he is positive for HSV 2, then you need to decide how much risk you are willing to take and whether condoms should be used in your situation or not.
Any outbreak at this point should be swab tested and typed.
I think you are missing the supplemental results. LabCorp does a supplemental test for anyone with an index value that is positive and below 5.0 The last thing you posted is not the supplemental.
There is very good agreement between the Labcorp supplemental negative and a negative western blot. If your supplemental is negative at 8 weeks out, despite the low positive IgG, I think infection for you is very unlikely.
I think you do need a test. It would also be useful to know the index value of your current partner’s positive test for HSV 2.
There is good agreement between people who get a negative supplemental and a negative western blot. Your IgG is so very low I would be very surprised if a western blot would be positive. Plus the information about your sexual history really doesn’t suggest a new herpes infection.
We don’t know if there is any cross reactivity between those vaccines and herpes antibody testing.
it takes direct contact to transfer virus from your husband to your child.
You asked if your child would be severely ill if they acquired HSV 1 at 10 months. The answer is likely not. I ran this question earlier by an expert in neonatal herpes and he indicated the child would be OK if they acquired HSV at 10 months.
You can put her bottles in the dishwasher, that’s fine for cleaning
Do you think your husband would consider going on suppression while your baby is still young, this seems to worry you so greatly?
I don’t think you can make anything specific of your testing at this point as the testing you had done was only 4 weeks after a potential infection. I do think that you might be jumping the conclusion that this is HSV without enough evidence. The blisters do sound discouraging, I know, but normally people don’t report herpes lesions as pin head blisters – they are normally more remarkable. Do you know the HSV status of the partner with whom you had sex?
Your IgG test for HSV 1 is still well under the cutoff for positive – I’m confused about why you think that is throwing things off?
A PCR would only be positive if there was virus present at the time of the swab.
As I mentioned, the IgM is useless due to high rates of false positives.
What you need is an IgG test which is more accurate.
No, herpes would not ever show up in 5 hours.
You mention that your partner is negative but if that is also an IgM test, that is not useful
I’m afraid that is all the help that I can give you without further better testing.
I don’t feel that you need the western blot, no. This is a sound negative and I don’t believe that you need any further testing based on the result. However, the IgG testing misses 30% of HSV 1 infections so if you are particularly concerned about HSV 1, you could do the western blot
I have a feeling that you are not in the US. But now that I know the reference ranges for wherever you are, it seems that your HSV 1 is strongly positive. Your HSV 2 appears to be quite negative. I just don’t know what to make of that urine PCR. This is not a standard practice in the US as herpes is not often in the urethra.
You are most welcome. I’m so glad you pursued further testing.
I would say that if you are on acyclovir twice a day, the approximate risk of transmission to your partner is about 5% in a year – that is, about 5 women out of 100 will become infected having sex about twice per week without a condom. You could do some daily home swabbing, but I think you would need to do it about three months for any accuracy and that is spendy.
What was the index value of your IgG test? If it were below 5.0, I would recommend a confirmatory test. Acyclovir would never cause you to have herpes symptoms so that’s not what is going on here. Let me know the value of your test result. Also, herpes does not cause symptoms for weeks as you are having
- This reply was modified 1 day, 5 hours ago by Terri Warren.
It is unlikely that a PCR done that late will be accurate but it could be if there was still lesion material present.
Herpes lesions don’t get infected normally, so I see no reason for that instruction. Yes, it might make the swab less accurate.
AGain, it didn’t sound herpetic to me.
There is a small risk of acquiring HSV 2 orally by giving someone with genital HSV 2 oral sex.
If the fingers of the male are intact, there is no risk of transmission to his fingers by inserting them in the vagina of a woman who has herpes. We also don’t believe that herpes is transmitted through hands in the way you ask.
I have had so many false positives with that company, I’m sorry to say. I don’t fully understand their cutoffs, but since this is a life long issue, if I were you, I would do the western blot for clarity.
It is possible to have a low positive 2 weesk after infection. By 3 weeks after infection, 50% of people who are going to be positive will be positive, so absolutely, someone could have a low positive index value 2 weeks after infection.
Most often, numbers will increase after a new infection, correct.
You can consider this a false positive if you wish. I’m afraid I can’t give you a 100% certainty here.
It is possible for someone to be truly positive 15 days after acquiring HSV 2, absolutely. But I do think the odds are that this is a false positive.
I would agree with both statements. I cannot say that there is zero risk of acquiring HSV 1 genitally, but if there is a risk it is incredibly low.
People really do want 100% certainty about these things, but we just can’t give it. But you live without 100% certainty in your life all the time and you must with this kind of thing as well.
You are asking a very specific question for which we don’t have an answer. We don’t know if at 8 years out there is a lower risk of transmission than at say 5 years out. We just don’t have those answers, I’m sorry.
I have never seen an indeterminate result become a positive one. I had one patient who had done a western blot (not through me) who had an indeterminate and then a positive blot. She asked me to have UW look at the blots again. They determined that the first one was a very close presentation but should probably have been called positive the first time around. That is the only case I have ever seen where it went from indeterminate to positive, but not really, as it turns out.
As you may know the western blot picks up 95% of HSV 1 infections and 99.9% of HSV 2 infections, so it does miss a few HSV 1 infections. Nothing is perfect here.
If I were you, I would probably believe that with a high degree of certainty, I didn’t have HSV 1 infection.
There is no way a single dose of antivirals would mess up a western blot, absolutely not.
When you say that you’ve had oral HSV 1 since childhood, are the sores you experience internal or external?
Yes, the percentages that you quote are accurate.
I don’t think retesting would be useful, no.
Urine PCR is not a standard method of testing for herpes at all. Where was this done? So had a sore in the genital area? Do you have a history of cold sores to account for your HSV 1 positive IgG test? I have to say I have never seen an IgG anywhere near 150 in my career before. is this the same lab that did the urine PCR?
You could get a final IgG test at 12 weeks out, but I’m guessing it will be the same as the 9-week result.
That is a PCR – nucleic amplification assay. Same.
I will have results back from the IGG test and the swab next week and I guess that should help clarify things. Until then it’s just a waiting game?
Should I go on Valtrex?
What’s suggested topically to place on redness/breakout/discomfort areas of the skin?
There is no suggested topical medicine in your situation because we have no idea what it is so don’t know what to apply
Should I go to an urgent care every time something pops up? or wait to schedule with health clinic or PCP?
Do you think you might be a little bit too reactive about any redness or abnormality on your skin? The things that you suggest really don’t sound like herpes to me.
Can I send pictures to you?
Also the right side of my penis hurts like internally maybe and I do often get the feeling as if something is happening or a possible outbreak may happen so it doesn’t help with trying to not think about it for awhile.
I wonder if you are paying a bit more attention than you need to for any sensations in your penis area? If you didn’t know she had herpes, would these sensations worry you?
1.) If I do have HSV2 how do I know if I’m potentially at higher risk due to lingering symptoms of an outbreak or not. Just for the future I would want to be as safe as possible with a partner to not transmit it to them.
I think you should redo the IgG test 6 weeks out and if negative, repeat in 12 weeks out from the encounter with the woman who told you that she has genital herpes.
2.) I went to labcorp for my first blood test and for the second one with the swab from my PCP it looks like they’re using quest diagnostics. Are these the same? Is a .91 considered negative or equivocal? What’s the gold standard for all testing considered to be equivocal because I feel like it changes often with different test.
<.091 is negative. 0.91 exactly is equivocal. both labs use that same standard 3.) Why is it suggested that so many folks take the western blot with equivocal IGG if only one has ever come back positive in your years of practice. I noticed you mentioned this on another persons thread. Sorry I been frantically doing research all month and scanning through other peoples post. People with equivocal results do the western blot just to be certain - they are uncomfortable with a test that isn't a clear negative or positive. The chances of you getting genital herpes from a single unprotected intercourse are really very low. You have no idea if she has HSV 1 or HSV 2, apparently, and since it is has been a long time since she's had an outbreak, it may well be HSV 1 which you already have. And if it is HSV 2, she is likely not shedding terribly often either since her outbreaks are very far apart. I certainly hope you aren't still with this person as your worries and fears would be hard for her. Some people can handle a relationship with someone who has herpes, others just can't. It's not a judgement - just a fact. Terri
1. Do my assumptions of my status (OHSV-1 and GHSV-1) make logical sense?
I honestly can’t say. If you do have HSV 1 orally, which we honestly don’t even know for sure, it is very unlikely that 10 years later you would get a new HSV 1 genital infection that would then go on to last two weeks. ingrown hairs on the lip really don’t look quite the same as oral HSV 1 but I suppose that they could be confused. ANd your partner may or not may have not acquired HSV 1 from you – she could have contracted it years before and just had a recurrences (unless she has never received oral sex from anyone in her life). It is all a bit uncertain to me.
2. What are the odds of my passing on GHSV-1 to a future partner via intercourse and what are your thoughts on my need to disclose?
Well, we have no idea that what you had was HSV 1 genital infection, first of all. Since you tested by antibody test immediately after the sore appeared, it could be HSV 2, it could be something else. We just don’t know.
And if you want to assume that you have HSV 1 orally, which we also don’t know for sure, I would recommend disclosing that prior to giving someone oral sex “Just so you know, I have the cold sore virus”.
If you were my patient, I would recommend the western blot. the IgG test misses 30% of HSV 1 infections.
You are making several assumptions here which may or may not actually be true.
The scenario that you present is not a risk for transmission of HSV 1.
No, this is not a method of transmission of HSV 1. And you’ve already paid because you were able to post.
THe first part of your question is a bit confusing to me. If someone had a genital lesion that tested positive for HSV 1 and they had just had sex with someone who then acquired HSV 1 genitally, yes, I would think that was genital to genital transmission. HSV 1 does have a preferred location and it is the oral area. It is true that I have not seen a case, personally, of someone with new genital HSV 1 infection that has not received oral sex in the past two weeks. GEnital to genital transmission of HSV 1 has been documented in the literature, but most of us have never seen this (without oral sex in the mix).
It isn’t that HSV 1 is in some sort of weakened state genitally, it is that it doesn’t like being there so it is rarely active there, especially after being there for a while.
We know that condoms reduce transmission from females to males by 65% – that is the work of Dr. Anna Wald.
Dr. Christine Johnston is the person who does most of the research into HSV 1 genital infection at this time. I have certainly seen her slides on this topic but I’m not clear if she has published this data yet.
It is very likely a false positive. There is good agreement between a negative supplemental test by LabCorp and a negative western blot, when people do both. Mono could certainly cause an outbreak of cold sores, though they are not enough intraoral, it could be. I think it is likely that there was some cross reactivity between HSV 1 and HSV 2 on the IgG test.
So you have a yeast infection. Or at least had one.
The IgM really doesn’t help us at all. How did his IgG test come out?
If you had unprotected intercourse with him only once, the risk of you becoming infected is really quite low.
The CMV is not causing the test is to be reactive, but we don’t know why the IgM is so inaccurate.
Only IgG testing is useful.
Wait – exactly how were you diagnosed and what type of HSV do you have?
I never say never, but the odds are just incredibly incredibly low.
1. I would think if it has been years since this happened and you’ve never had a cold sore and you test negative, I think you should put this worry away.
If you want extra certainty, do the western blot and get this settled.
Yes, genital to genital sex has some risk, that’s correct.
The stats you quote from the transmission trial are the lowest we’ve seen so I would wonder if it would actually be lower for you, I might guess not.
Correct, there is no simple way to know when or if you are shedding virus genitally. We do often see oral and genital symptoms at the same time, so you could try swabbing when you have finger symptoms, yes, both finger and genitals.
TerriSeptember 19, 2022 at 4:28 pm in reply to: HSV-2 18.6 Index High Positive with no symptoms. Still possible False Positive? #78812
We do not, but it is some non-specific protein and I see more higher false positives in immigrants to the US and their children and also some more in African Americas.
Oh believe me, it’s possible! I see it more and more often.
I believe that I answered this question on the other site.
When you say that you tested positive by blood, and it was by IgM, you simply cannot trust this test. Do you have questions beyond what we discussed on the other website?
There are therapeutic vaccines in the works, yes.
You need to do an antibody test a few months in the future to find out for sure if you now have HSV 2 or not.
Often someone tells me they have a blister in the genitals but when I meet them online and see photos, I would not describe these as herpes blisters.
It is possible that it is on your finger only, but we simply cannot be certain. This has to be frustrating for you, not knowing for certain if you have it also genitally.
Yes, because oral HSV 2 is so uncommon, we have no data on transmission and acquisition that is correct. There are no studies that I am aware of that address this question at this time.
I would strongly suggest that you have your finger swab tested for HSV the next time this happens. Be certain to ask that the virus be typed IF it is positive for HSV.
If your husband is negative after all these years, it certainly suggests that viral shedding is rare if you do have it genitally.
I am assuming you’ve had other sexual partners than your husband at some point in your life?
- This reply was modified 2 weeks, 4 days ago by Terri Warren.
When you keep posting more as you have, it makes me think this is a newer post not an older one.
Taking antivirals for that short a time that long after a low positive, would not impact a new test. I still suspect that you are not infected with HSV, given your negative now.
What are the the chances of a male getting infected from him performing oral on me? I have seen many posts saying that genital to genital contact would be low, but I am so confused about oral.
The risk is also low because HSV 1 genitally is so rarely active. It’s more about the behavior of the virus when it is located genitally than it is about which body part is being exposed in the genital area, mouth or penis. At seven years out, you are likely shedding very infrequently indeed.
Also would you suggest I be taking suppressants daily when I am going to be sexually active? I would prefer not to, but want to know for sure. I have had an allergic reaction to Acyclovir so I would only be able to take Valtrex.
If you are allergic to acyclovir you are also allergic to Valtrex as it is the pro drug of acyclovir. Also, because HSV 1 genitally after so many years is going to be so quiet, it is doubtful that antivirals would improve your viral shedding situation much if at all.
1. If he is willing to start taking daily antivirals and to use condoms, am I at a higher risk for catching it (my rheumatologist told me yes, but I’ve read conflicting information)?
I would say probably not, but we don’t have good research done on this question. But if he is doing both religiously, I think your risk is incredibly small
2. If I caught it, would I be likely to have frequent and severe outbreaks and complications?
Also hard to know for sure, but if you were on suppressive therapy, it would likely control outbreaks for you as well.
3. Does the ease with which I caught HSV1 on my breast or the mildness of the symptoms provide any clue on how I might be affected by GHSV2? I’m wondering if I was just lucky to have gotten it in an odd location and that made my symptoms mild.
Since you already have HSV 1, if you got HSV 2, your acquisition would likely be milder than for someone who does not have HSV 1 already.
No, if your exposure was only genital, symptoms on your mouth would be unrelated.
The lesions that you describe sound far more like yeast than herpes, due to the duration and positive response to yeast medication.
I would advise that you wait 12 weeks from the encounter and retest. If positive again at the low positive level, like where you are now, get a western blot for confirmation.