[Question #1419] Herpes Transmission Risk

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91 months ago

   I am recently divorced after being married for 21 years. My ex-wife told me when we first met that she had herpes. I am not sure if she was ever tested. We had unprotected sex for 15 years without any problems then I noticed some minor sores near the head of penis. I also felt slightly ill along with these symptoms so I assumed I had contracted herpes from her but I did not get tested. I noticed these mild sores on my penis once or twice more in the following year or so but then no more occurrences.

I have not experienced any symptoms for at least 5 years. I finally got tested for herpes in January of 2016 and to my surprise the test came back negative.

HSV1 IGG Type Specific AB <0.90

HSV2 IGG Type Specific AB <0.90

My questions are:

Do I have herpes?

If so, how much of a risk is there of me passing herpes on to someone else?

What are risks of transmission with and without condom use?

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Terri Warren, RN, Nurse Practitioner
91 months ago
I don't know at this point if you have herpes or not, but if you do, I think it is more likely that you have HSV 1 than HSV 2.  The IgG test for HSV 1 misses about 30% of infection, the IgG for HSV 2 misses only 5-7% of infections but as you can see, neither test is perfect. The gold standard test to which the IgG test was compared in the study described above is obviously better.  If you are interested in knowing for sure if you have herpes and if so, which type, can be obtained through the University of Washington - Google UW and herpes western blot and you would find the number to call to order the test. 

Let's assume for the moment that you do have herpes and let's assume first that you have HSV 2.  Without condoms or medicines having sex about twice per week and assuming the person knows your stauts, the risk is about 10% per year.  With daily antiviral therapy, about 5% per year and with condoms, perhaps 1-2% per year. 

If you were my patient in your situation, I would strongly suggest the western blot.  I think, given your description of symptoms and history, herpes is likely, but with the recurrence rater, more likely HSV 1 than 2.