[Question #101] Low Positive

38 months ago
To whom it may concern, 


On June 24th I had a routine blood test. My doctor asked if I wanted herpes included and I said yes. It turns out that my results came back with the following...

HSV 1: >5
HSV 2: > 1.5

My last possible exposure was on May 12th. Now I understand that my value for herpes 2 is is a low positive and I plan on getting a western blot test done, however my question is in regards to symptoms. 

The only "symptoms" that I have had is I remember finding a pimple on my scrotum once several months ago, and occasionally I will experience a discomfort, although not really painful, inside the tip of my penis. It usually lasts for a few days and then goes away. 

In May I broke up with my girlfriend and we were together for 1 year. We did have unprotected sex regularly throughout our relationship, however began using condoms again in March due to her going off the pill. 

I have not told her about my diagnosis yet because I want to find out if I have it for sure before I freak her out, but there are some issues that she expressed to me during our relationship and I am wondering if you feel that these could be herpes symptoms. 

For one, she had what she called a UTI last summer that ended up turning into a bladder infection (at least thats what she told me) and she ended up having to be hospitalized. She also had mentioned once that she has female issues regarding an unbalanced ph level (again this is what she told me). Throughout the course of our relationship there were times when she said she couldn't have sex due to issues she was having with her vagina. She would either describe it as a uti or just general discomfort due to this seemingly reoccurring problem. I am not sure though if they were uti's though or problems arising from her unbalanced ph.  

In December she had an abnormal pap smear which ended up not being caused by cervical cancer. I understand that herpes can indeed influence a pap smear test. I am wondering if you believe that her symptoms that I described seem to you to be herpes, in light of my positive test result. 


Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Good morning John,
Sorry it has taken me a bit to get this answered - I am en route to New Zealand.  At 1.5, there is an 85% chance that this is a false positive result for HSV 2.  The abnormal pap smear is most often caused by HPV, not HSV. 
Nothing you have described above sounds like herpes to me, actually 
Please let me know what other questions you have.

Terri
---
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Oh, and as for telling your partner that you have herpes, I don't think you need to at this time.  What you need here is the herpes western blot.  Our clinic can order that test to be drawn at a lab near you and shipped to the University of Washington OR you can contact uw directly and have a kit shipped to you to be drawn by your own provider, spun down and shipped back to UW.  Which  ever works for you is fine, but this is what you need to find out if this is a true or false positive.  The odds are in your favor here, for sure, but not enough that you can assume for certain that this is a false positive.

Was the last time that you had sex in May?  You'll want to wait about 16 weeks for the most accurate western blot.
Again, none of your symptoms sound herpetic to me.  Her symptoms are more vague and I can't really say what all of that might have been for her.

Terri

---
38 months ago
Thank you for your response! 


Yeah I know what you mean, I wish I had thought to ask her more about those symptoms at the time. I don't know very much about women's health issues but I guess I'm wondering if those issues she was having are common based on either the discomfort she was experience or what she told me she had. She is 22 years old. 


Thank you ! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
It may not be as much of an issue of what she told you she had but rather an issue of her actually being accurate about what she had.  Lots of people with herpes confuse their symptoms with other things, and unfortunately, so do their health care providers.  Are you in a position with her to ask her to get tested, do you think?

Terri
---
38 months ago
I could ask her to but I would prefer not to unless it is likely that she/I have it. Based on your response is it fair to assume that based on what I described to you it sounds like she may have had it? Should I still go by the 85% chance that it was a false positive? I'm just confused as to what her symptoms are, does it seem likely to you that those symptoms are herpetic or no? 


Thanks! 
38 months ago
Is vaginosis or utis something that could cause symptoms every couple months? Or even for frequently because she did mention those conditions 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
38 months ago
Bacterial Vaginosis causes a fishy odor, a gray discharge but usually not irritation (it is an "....osis, not an ....itis because of lack of inflammation).  I'm sorry, but I cannot know what was going on with her.  BV and UTI could occur frequently, yes.  If you were our patient, we would run a western blot on your blood because of your index value.

Terri
---