[Question #2068] Herpes-2 infection and testing results

47 months ago
I recently had a comprehensive STD test.  All tests were negative except for HSV-2.  It states that the HSV Type 2- Specific Ab, IgG, Type Spec was 14.00 High.
I am 64 years old and have never had any outbreak.  I am bisexual and have had 1-3 partners per year for the past  14 years.  I only had oral sex 3 times where we ejaculated (male-male) and protected anal sex twice.  Have have engaged in oral sex both giving and receiving without ejaculation on numerous occasions.  What does a score of 14.00 mean as I can find nothing referring to that high a number anywhere.  In addition, if I do not have an outbreak, am I still contagious to others.  Finally, should I get retested?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
An index value of 14.0 on the HSV 2 IgG test suggests a well established HSV 2 infection.  We do recommend confirmatory test for those whose index value is 1.1 to 3.5 but I see no need to confirm a test result of 14.0.  People who have HSV 2 infection, even without symptoms, are still potentially infectious to others.  People who are completely asymptomatic but HSV 2 antibody positive shed on about 10% of days measured - those with symptoms shed virus on about 20% of days.  The reality is that  most people actually do have symptoms, they just don't recognize them.  You want to be observing all throughout the boxer shorts area - outbreaks can occur on the buttocks, anus, thigh, low belly, and of course genitals.  Your outbreaks could be mild - you could confuse them with "friction burns", penis caught in zipper, hemorrhoids, lots of different things..  I think now that you are diagnosed, you will likely to be able to recognize an outbreak. 
Please let me know what other questions you might have.

Terri
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47 months ago
Thank Ms. Warren:  One follow up.  If my life partner and I have not had any sex for the past 8 months and none for the 6 months before that (each of those one time), and she has not any  symptoms, if we abstain from all sex in the future, is it likely she will never have an outbreak?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
I don't know her antibody status for HSV 2, do you?  If she is negative now and you never have sex again, then she isn't going to get this from you.  But that seems very extreme to me!  If you use condoms and take daily antiviral medicine, the chances of infecting are very low indeed.  If she has not had a test, she should.

Terri
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47 months ago
But if she has not had outbreak ever, what chance is there she will have one in the future given my history.  Telling her about this will upend a 45 year old relationship.  I could not deal with that anguish.  Not having sex is not drastic in this otherwise great relationship.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
I'm not sure I understand your question but I'm guessing that you mean if she is infected already and hasn't had an outbreak yet, what are the chances that she will?  That's very difficult to say.  She could be having outbreaks already and doesn't know what they are or attributing them to something else.  Or if she becomes ill and immunosuppressed, she could start having outbreaks.  And then she's going to wonder how on earth she got herpes, even if you don't have sex anymore.  To me, this seems a very big thing to keep from a partner of 45 years, but your call.  Without knowing if she is infected or not, I cannot say if she will ever have an outbreak in the future.  But then I don't really understand why, after 45 years, you decided to get an STD panel, but I'm guessing there might be  a story there somewhere. 

Terri
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