[Question #11390] HSV-1 Titer change to non reactive Am I Negative now?

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14 months ago
I am 62 year old male.  Negative on both HSV  in Oct '24 until Dec 15, 2023 HSV-1 titer 24.  Rechecked and titer drop to 6.85 on Feb 7, '24.  No oral nor genital lesions at all.  Last partner said she never even had a cold sore, no answer on titer!  I started taking Valtrex 500 mg once a day March 11 to protect the woman I started dating who is negative for both HSV.    I took another titer (all IgG tests) test and became non-reactive at 0.562 on 4/14/24!   Rechecked again on 5/14/24 at 0.559 (<0.9 non reactor).   I read about neutralizing antibody especially in people over 50 and wondered if my body was able to clear it on its own.  I did not read anywhere that the taking of Valtrex would make the titer drop to below reactive levels.  Is this something that happens to everyone on Valtrex or did I have a miracle (I prayed to God to clear it and neutralizing antibodies could do that!)   If this is common place will going off the medication allow it to go back up.  I would like to stop the RX and recheck a month later.  However I do not want to do that if sexually active.    If I remain non-reactive off the RX am I negative and cured? 
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Terri Warren, RN, Nurse Practitioner
14 months ago
I'm so sorry to have missed this post!
You did not clear this on your own but you may not have ever had it, very hard to know because the HSV 1 IgG is a poor test - it misses 30% of infections compared to the gold standard herpes western blot.  Meds would not impact the herpes western blot so if you want to know if you really have HSV 1 then you should get a blot.
I'm not sure about titers - we don't see them anymore, but you had an index value of 24, then you are almost certainly infected with HSV 1, but it if is a titer, that's a very old indicator of infection and I can't say how reliable it is

Terri
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