[Question #12020] HSV 1 / testing question
10 months ago
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Good Afternoon,
specific questions for Terri if possible since this is a Herpes question. I tested for HSV 3 weeks post last exposure last month (exposure unprotected vaginal multiple times, one time anal and multiple times oral sex analy and vaginally and giving oral) with a new partner (no longer active w them and haven’t been since) in the month of July and came back 7.20 IgG for HSV1. Do you suggest retesting ? No visible signs of oral or vaginal herpes. Pcr test (swab) was done on an area of concern but was negative for hsv 1 and 2. I see it’s not conclusive till 12 weeks post exposure and is that w the blood test again or western blot? Was curious if this meant I should retest. Last question, what’s your opinion on disclosing Hsv1 to potential future partners? I do not deal with cold sores as far as I can tell. It’s very likely I have had them before and dont remember / didn’t think much of it. I am aware it is possible hsv1 could be vaginal.
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Terri Warren, RN, Nurse Practitioner
10 months ago
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The 12-week waiting time is for the western blot.
You are correct that without a lesion vaginally or orally, you can't know if your infection is oral or genital.
So to be sure I understand, the multiple contacts that you had with this partner were in July and your testing was in August? Was the testing done three weeks past this encounter? I strongly suspect that your HSV 1 infection was established before this encounter. It would be unusual for someone to be infected for only three weeks and have an index value as high as 7.2. Have you been tested for HSV 1 in the past?
I don't see a reason to retest. In our research studies, almost everyone who tested above the index value of 3.0 was confirmed as positive for HSV 1.
Let me know what further questions you may have.
Terri
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10 months ago
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Hi there, the was my first time testing for Hsv1. Aware that it is most definitely from before the exposures in July. Was just wondering if I should retest for Hsv for the encounters in July. Yes this test was 3 weeks from the last exposure from July. What’re your thoughts on disclosing hsv1?
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Terri Warren, RN, Nurse Practitioner
10 months ago
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oh, could you have acquired HSV 2 at the encounter? That is possible, yes, but it might be a good start to ask the partner if he would be willing to test for HSV 2.
There are various ideas about HSV 1 disclosure. If you have never had a cold sore and are infected orally, you can still shed virus intermittently. If you have it genitally, shedding is far less likely but probably not zero but pretty close if you've been infected for more than two years. The thing is, you could shed a virus even though you don't have symptoms, which means you could infect another person who is HSV 1 negative. I am in favor of disclosing that you have the cold sore virus but have not had an outbreak that you are aware of. Other clinicians may say there is no need to disclose. But I've been involved in too many law suits of people suing one another for HSV 1 transmission to think it is benign.
Terri
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10 months ago
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from what i know this person says they tested for and were negative for everything , i was never shown proof / exactly which ones he tested for and we do not speak any longer. being that i did not have clear indications of herpes 2 and had a negative pcr swab, negative igg although tested too early for that regarding if hsv2 would show, would you suggest retesting for hsv2 igg? it has. been 3 months at this point. wondering whether it’s necessary as i see hsv testing isn’t recommended unless clear indication of it
10 months ago
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i just want to clarify i had intense burning each time after having sex with this burning for days. i did not have obvious lesions, only two spots that looked a little raw to one doctor and she did a pcr swab on them and they came back negative. this was 3 weeks since the last exposure when they were swabbed so i’m not sure if it was too late? again no obvious lesions/ scabs/ oozing or anything just redness and two spots that were sensitive to touch. when said spots were looked at by others they said they didn’t see anything concerning. i did test positive for vaginal candida and bv so im not sure if this was the reason for that? so far im thinking i either may have genital hsv1 which the igg is positive for or it was a yeast situation. or i was exposed to hsv2 and had a first outbreak? although seems odd since i didn’t have any herpes specific lesions as far as i was told / am
aware. i just am wondering if additional
testing for hsv2 igg is necessary / wouldn’t want to have it go undetected and pass it to someone without knowing.
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Terri Warren, RN, Nurse Practitioner
10 months ago
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If you have never had a cold sore on your lip or inside your nose, then we cannot know if your HSV 1 is genital or oral (assuming you've received oral sex in your lifetime).
You could test for HSV 2, but the issue is false positives on the traditional HSV IgG, so if you test positive, be prepared to do a good confirmatory test called the western blot from the University of Washington or just start with the western blot and skip the IgG test. This is probably a matter of peace of mind vs. a medical reason since your symptoms have been minor. But I understand that you don't want to pass on HSV 2 if you have it and it has so far not been detected.
Terri
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