I have had HSV1 (only cold sores in mouth from kissing) since 2017. I sometimes briefly take valtrex if I have a breakout or think I’ll have a breakout in my mouth. On 13 May 2023, I had unprotected vaginal sexual intercourse one-time with a woman who had HSV2. She told me afterwards about the HSV2 but tried to assure me she was fine due to taking Valtrex regularly (I think daily). Exactly 11 weeks later (31 July 2023), I took an IGG blood test and was negative for HSV2. I’ve never seen symptoms of genital herpes. At the time, I was fairly confident in my test results, especially after posting a question here. I recently ended a relationship and went to see my doctor for a check-up. The doctor ordered numerous STD tests and all have come back negative so far. I wasn’t concerned about this recent relationship but regularly get tested for STDs to be safe. While talking to the doc, she told me that she doesn’t order HSV1 or 2 testing and I didn’t think she was testing me for it also. However, my online medical profile shows I have a pending HSV1 and HSV2 IGG test result. I’ve read that IGG tests often have false positives. My question is…if I happen to be positive for HSV2 on this IGG test, should I get the western blot test done? What is the likelihood of contracting HSV2 from a one-time vaginal sexual intercourse? High, low? 

Another question…prior to taking the 31 August 2023 IGG test, I may have taken Valtrex at some point. I can’t recall specifically but I will take it if I feel like I’m having a cold sores breakout. Usually, it’s only for a few days if I use it. I don’t recall if being longer than a few days (maybe week). Typically, I just take a large dose morning and night on one day. What impact could that have on my negative HSV2 results in 2023 that were tested 11 weeks later? Again, not certain if I did that during the 11 weeks post sexual intercourse but thought I’d ask.

Also, my index for the 31 July 2023 HSV2 IGG test was at .085 at 11 weeks post unprotected vaginal sexual intercourse. I didn’t know if you needed this information or would be helpful.

Yes, there are many false positives on this IgG test and that's why it is no longer recommended to be included in STI screen.  If you get a positive IgG test, given your previous negative igG test, I would most certainly recommend the western blot.  I think I would also call and ask that the test be cancelled due to the recommendations against it being done, by the CDC and FDA.---

Thank you for the response. Fortunately, my results came back negative yesterday for HSV2. I am very relieved. Had the office been open over the weekend, I would have had them cancel the test. I suspect the doctor ordered a full battery of tests and apparently HSV1 and 2 was included…she was adamant when we met she didn’t usually do the HSV tests. Oh well, I guess it doesn’t matter now since I was negative. I also assume I should be able to trust this result?

The virus is spread through kissing and giving oral sex.  To reduce that risk, you could consider taking daily antiviral medication and certainly avoid those activities when having an outbreak, but the virus can be transmitted while asymptomatic.---

I’ve never heard of taking daily anti-viral for HSV1 cold sores. Is it the same dosage as someone who takes for HSV2 for genital herpes? Are there serious side effects for daily use? I’m 53 and try keep my blood pressure and blood sugar managed. I’ve never been diabetic but have been pre-diabetic. I workout frequently and try to eat healthy and keep my A1C in a healthy range. I know that some drugs can have significant side effects in long term of uses.

The dose is 500 mg once a day and the meds are safe and effective.  I take 500 mg daily to prevent cold sores.---