My female partner of 10 months went to a new primary care doctor who tested her for hsv1 & hsv2 as part of her initial check-up despite having no herpes symptoms or known exposures. Her Labcorp Roche antibody test results came back positive for hsv1 & hsv2. She retested 2 more times over the next month and each time results were positive for hsv1 & hsv2. At least one of these tests was in the range of < 3.5 however. I also got myself tested 3 times (twice w/ Labcorp Roche, once w/ Quest) over a 4 week period after she told me, and I tested negative each time for hsv1 & hsv2. My primary care physician told me based on these antibody test results that I should conclude that I'm negative for hsv1 & hsv2 and that she is positive for both types. Neither of us has ever had any herpes symptoms as far as we know, but we have never been tested for herpes prior to this either.  We have had previous sexual partners prior to this relationship that may have exposed us to herpes. Before we became sexually active in this relationship, we both got a STD panel of tests (which did not include herpes testing). We've been having unprotected sex in this monogamous heterosexual relationship for the past 7 months so it's surprising that, if she had hsv1 & hsv2 during this time, that I haven't tested positive for it too. I'm concerned about the antibody tests being a false positive for her, or possibly a false negative for me.  Do you recommend either of us getting a confirmatory Western Blot test since neither of us have any symptoms and we cannot do a swap test without a lesion? For discordant couples, what is currently the best method to reduce hsv1 & hsv2 transmission from a female to male besides abstinence - is it condoms and her taking a daily dosage of antiviral medication such as Valtrex? What is the transmission rate for using both condoms and antivirals, assuming this is what you would recommend for transmission prevention?

I'm confused because the Roche test only gives reactive or non-reactive, not index values, like <3.5.---

Thank you Terri for this info.  Sorry for the confusion.  Her Roche test results show "reactive" for both hsv1 and hsv2.  

The western blot would confirm these results, yes, but I think there is a very good chance that they are correct.  The Roche test has about a 2-3% false positive rate, so there is a small chance that this is an error.  ---

Thank you!  I don't know if my partner would choose to go through another test, given the small chance of error in the ones she's taken so far. Please correct me if I'm wrong but I saw somewhere that the herpes western blot herpes is 99% accurate - slightly more accurate than Roche. RE: the best methods to reduce hsv2 transmission.  So condoms reduce transmission from women to men by 65%..  assuming I'm "negative" for hsv2 and we strictly used condoms without her taking antivirals, does this mean on an annual basis that I would have a 33% chance of becoming "positive" for hsv2 having sex twice per week?  A 33% chance is a pretty high risk of transmission in my opinion when compared to that risk being reduced to 1-2% by combining condoms and antivirals. Can you explain a little more about an infected individual being able to identify hsv2 symptoms in themselves usually 3-6 months after being diagnosed?  Are you saying that a person infected with hsv2 is better able to identify whether or not they're having an outbreak after they've become aware of their status?  Is that just due to a heightened awareness?  One of my concerns has been how do we know what to look for so that we can avoid sexual contact during an "outbreak" when hsv2 seems to be most contagious. I'll schedule a Roche retest for hsv1, and hsv2 while I'm at it, since 15% of hsv1 infections get missed in the Roche test.  Do you have advice for preventing hsv1 infections?  Should we refrain from certain things during non-outbreak periods? Thank you for the online prescribers idea!  My partner may like some counseling for herself on living with hsv1 and hsv2, or a couples session for us.  Do you offer telehealth sessions for these types of herpes questions?

No, it doesn't mean that.  The baseline risk, having sex about twice per week with no symptoms and no condoms and no meds is about 4% - 4 men out of 100 might acquire HSV 2.  ---

Understood on the transmission rates, and reasons why we more easily identify symptoms.  Thank you Terri for answering so many of my specific questions.  I'll talk to my partner about counseling.  Again, thank you so much for your care and helping us make informed decisions moving forward!

you are most welcome, Marc.  Let me know if I can be of more help at westoverheights.com---