[Question #1954] Confused about results, sex advice

46 months ago
Last year I was tested via igg blood test for hsv1/2. Both came back neg. Around Feb21 this year, after a weekend of unprotected sex w my boyfriend of 7 yrs, I felt back pain, fever, chills, and other uti problems. First uti ever. Went to minute clinic and was diagnosed with uti and was sent  home with antibio. Went to hospital two times after bc I still had a fever. It was during the 2nd visit, I was on my period and noticed blisters on my inner labia. Dr at hospital check them and said they looked like herpes. She did a cervix check and it was very terrible pain when she inserted her fingers.  I was blood tested again for herpes after the uti symptoms subsided on feb 28 and it was again neg. Next period I again saw sores. On March 29, a blister swab was cultured on one of my sores and tht came back pos. Question is, how can one test be neg and one be pos? I've read that means it is a recent infection which does not make sense as I have not slept with anyone else and I trust my boyfriend has not either.  Is it possible for me to have contracted the virus years before and show no signs of it in my blood or symptomatically until now? Did the uti somehow activate the virus/immune response antibodies? My bf is routinely tested for STIs including herpes, as his job requires it due to his position. He was tested for herpes on feb 14 and it was neg. Could he carry the virus as a result from past partners and it not be present in his blood and have no symptoms? He is getting tested again to c if I have passed it to him, results pending. If he is neg, what is the best way to ensure he does not get it? Can I take antiviral everyday and have sex without a condom? We want kids. Can he get hsv2 on his mouth if he gives me oral during no outbreak? Can I still get it somewhere else on my body, like mouth or anus? Help!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Which type of virus was isolated from the sore, HSV 1 or HSV 2? 
It's most likely that you have HSV 1 genitally, as the test for HSV 2 is quite a bit better than the one for HSV 2  The HSV 1 IgG test misses about 30% of infections compared to the gold standard western blot.  So you could have been infected by your boyfriend if his test missed a type 1 herpes infection (BTW I have never heard of a job requiring a herpes test - I suspect that might not even be legal).  The chance that his antibody test missed an HSV 2 infection is far lower.  This would most likely have been transmitted to you via oral sex, if it is new type 1.  Has he ever in his life had a cold sores?  Or you could have been infected for years with HSV 1 and didn't recognize and outbreak until February of this year.  Another possibility is that the infection is too new for you to have yet made antibody and that you will at some point - if you take antiviral medicine, that will slow you becoming positive on the antibody test.  Another possibility is that you boyfriend had an IgM test instead of an IgG test which would have led to a false negative or that you had an IgM instead of an IgG with the same result.  I suspect the UTI was actually herpes lesions IN the urethra as well as lesions on the labia. 

The best test for him would be the herpes western blot to detect HSV 1 if you know you have HSV 1 - I don't know what type you have and I don't know if you do either.  Can you let me know what so I can answer your questions with more accuracy?  Thanks

Terri
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46 months ago
Hi terri,
I was told the culture tested pos for hsv2. He nor I have never had any cold sores in our mouth area or in the genital area. By new infection, does tht mean he got it recently and passed it to me?  Or Cld he have hsv2 for all this time and I just begin  to show symptoms after 7 years and if so, why would the test last year for me be neg ? I dont know what test igg vs igm was done around the same time as the uti symptoms this past feb but I  know the test done a year ago was igg. 
 What test is best to get for hsv2?
I dont want to get too specific but his job requires lab work in the manufacturing of certain vaccines. They can't terminate him, but if he or anyone else tests pos for these infections or a few others, he can get transferred to a diff depart.
Also,   If he is neg, what is the best way to ensure he does not get it? Can I take antiviral everyday and have sex without a condom? We want kids. Can he get hsv2 on his mouth if he gives me oral during no outbreak? Can I still get it somewhere else on my body, like mouth or anus?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
OK, so if the swab test was positive for HSV 2 (you are certain?) and you tested negative by IgG one year ago, and he tests negative now by IgG and if neither of you has had any other partners since then, the test had to have missed an infection in one or the other of you.  The herpes western blot would likely be able to pick it up in whoever the test missed. 
Frankly, I cannot imagine a job where you can't have either type of HSV.  Almost two thirds of the US population has HSV 1 - but I guess both of you know the rules there better than I. 
If he is truly negative by western blot, you taking daily antiviral therapy and using condoms with every intercourse and not having sex when symptoms are present are the ways to reduce the risk of transmission.  HSV 2 doesn't like the mouth so infection there is uncommon but it does happen.  I doubt that you will get it orally if you don't have it there already but you could get outbreaks around the anus as that is in the same nerve group as the genitals area and the virus could travel along a slightly different nerve pathway and show up on the anus - it would not be a result of you transferring the infection.

This situation is really unusual.  One thing you could do pretty soon is do another IgG for HSV 2 - if positive now, it is far less likely that your tested missed a latent infection a year ago. 

Terri
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45 months ago
So my bf came back pos for hsv2 using the blood test.  He was tested back February  14 and that result was neg. As I mentioned before I was tested a yr ago and it was neg. I was tested recently arnd feb 28 and again arnd  March 23 and blood were neg but I resulted pos for hsv2 with the culture test when I had my second break out in March. Last sex encounter with bf was around feb 21. What do these results mean?  Bc we were both tested frequently does this mean he contracted it first and transmitted it to me since his blood test is coming back pos now and mine still neg? If it takes 3 to 4 months for abs to be produced cld that mean that he contracted it in October or November and transmitted it to me in February resulting in my initial break out? 
Also, can hsv2 be transmitted during a waxing session? Like reusing dipsticks somehow? 
I don't know  how to explain this to myself. I haven't slept with anyone else but my bf and he swears he has not either. I'm trying to find an explanation based on my results as to how this happened. 
I am going back to get tested in June to see if my blood test comes back as pos. If it is pos wld tht mean I definitely contracted it in feb? What does it mean if it's still neg?
How many breakouts is normal? I have had 3 since February so once a month since my first outbreak.
Thank you for your help.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
Your situation is very confusing to me s well.  Are we certain that all the tests done were IgG tests?  It would be worth checking on that by looking at your past records - sometimes an IgM slips in there.  Another possibility is that your antibody test is missing your infection and you were previously infected and didn't know it .  If his was negative in Feb. and is now positive, this suggests that he has new infection since then.  When was his last partner before the February test other than you?  If he had a partner within the 3 months prior to the Feb. test, he may have tested too soon after contact with them and his Feb test was a false negative. 
No, no transmission during waxing as the heat of the wax would normally kill the virus right away. 

I think you should both gather your results together, discuss the timing of other partners prior to February and try to sort this through. 
You are having more outbreaks than normal.  I would strongly suggest that you do on daily antiviral therapy for 6 months or so and try to get this pattern stopped for a while.  This is our last post together but you can renew if you have more questions.

Terri
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