[Question #1361] HSV 1 vs 2

46 months ago
I got HSV 1 from a boyfriend 6 years ago (he went down on me and he had a cold sore) so I got it on my genitals and not on my mouth. I got tested more recently and it said I was positive for antibodies 1 and 2, but I wasnt sure if that was because it was (down there) rather than on my mouth. I had (protected) sex with someone a year ago and I didnt have an outbreak (id had another boyfriend who didnt get it when we used protection) , but I am feeling guilty that I didnt tell him. Hes never said anything and weve been friends since then, I just dont know if it would do more harm than good to tell him a year later.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
So in order to help you best, I need to know the index value associated with your positive HSV 2 result.   It is a number associated with the result  Can you get that for me?  Sometimes there are false positives on the test, particularly if the index value is between 1.1 and 3.5
Type 1 HSV always stays type 1, regardless of its location on the body.  Did you have a positive swab test from a lesion in the genital area, is that how you know you have HSV 1 genitally?

Terri
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46 months ago
I know for sure about the HSV 1 because of the swab from the first breakout, but the results Didn't provide a number "This assay may not accurately distinguish between antibody to HSV 1 and HSV 2. Recommend HSV 1 and 2 glycoprotein testing, when clinically indicated."  It says negative for standard range
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
The swab test for HSV 1 would not contain a number - just positive or negative.  But the IgG test should.  When looking at the results for HSV 1 and 2, does it look like it is a combined test for the two types of antibody?  I think it might be because it is suggesting type specific test where clinically indicated and it also says it can't distinguish between the two.  I think the antibody test you are looking at is probably a combined HSV 1 and 2 test.  You need the one they are recommending that is glycoprotein testing that separates the two types of antibody.  Can you arrange that?

Terri
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46 months ago
Possibly, Im just wondering what the risk is if I did not have a breakout and we used a condom ( I am trying to decide if I should tell my friend or not)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
well, I personally don't think you need to notify your friend that you have HSV 2 because you don't know that you do.  In terms of the HSV 1, if you didn't have an outbreak and used a condom, I think the risk of transmission is very low and you don't absolutely have to tell - the experts disagree on disclosing genital HSV 1 anyway.  In this situation, the exposure was so long ago, I'm not at all clear that telling him about your HSV 1 at this point would be productive.  I do hope that you will get the appropriate antibody test so you can know for sure if you have HSV 2 or not - this is something that you need to have clarified.  Remember that you want IgG type specific antibody testing to determine this, not the combined test you appear to have gotten.

Terri
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