[Question #2082] HSV - 1

48 months ago
Dear Dr HHH,
I hope your doing well.
Today I received my Herpes Antibody IgG tests back, which shows that I'm diagnosed with Herpes type 1.  
The test shows that herpes I result is 49.2 and Herpes II is less than 0.5 which indicates it is negative, here is what is written on the Lab paper which I do not understand.  " Serological evidence of HSV infection at some time." 
However, I haven't been to my GP to start the treatment yet as I just got the email so I would really appreciate it if you help me first.

I'm the guy from London, posted twice here in regards to HIV as I had symptoms listed in the previous posts.  I want to know how accurate is my positive result of Herpes ? The tests were taken 14 weeks after possible exposure, am I out of window period for both Herpes types ? 
Sometimes there are debates regarding herpes tests accuracy, how accurate the tests I took? Do I need to test for Herpes I & II again ? I have kissed my girlfriend, have I possibly infected her ? 
I had sometimes ulcers on inner side of my lips which were hurting but were disappearing after a day but never thought they were due to Herpes?

I tested negative again for HIV 4th Gen, Syphilis and Hep B at 14 weeks, would diagnosing with Herpes I increase my chances of getting HIV or delay the antibody seroconversion ? do you still consider me HIV negative ? Just to remind you, I have had 11 HIV tests, nine of them Duo and two of them 3rd Generation in 14 weeks, all negative. 

My understanding of Herpes is very poor, so I would appreciate it if you tell me what to do, what tests to repeat, what treatment to take , how does this impact on my life  and what to avoid.

Many thanks


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Hello,
While Dr Handsfield and Dr Hook answer HIV/STD questions on this board, I answer the herpes questions.
Your positive HSV 1 antibody suggests that you have a well established HSV 1 infection.  I know you are in London, but as a frame of reference only, about 56% of Amercians between 14-49 have HSV 1 infection here.  The infection could be oral or it could be genital.  The ulcer inside your lips could be herpes, yes, but if you want to know with more certainty, you would need to have them swab tested when one is present. 
In a recent study we did that is about to be published, the HSV 2 IgG antibody test missed 8% of HSV 2 infections compared to the gold standard western blot, which means with 92% certainty, if you had acquired HSV 2, the test would have picked it up.  I think that's quite good albeit not perfect.  The bigger problem with the IgG test is that is misses about 30% of HSV 1 infections, but that's not an issue at all with you.
Treatment may not be necessary - it depends upon what you are trying to do - if you are trying prevent infection in someone who is uninfected, then daily treatment may be appropriate but without knowing the antibody status of your partner, I cannot advise you on the wisdom of doing daily antiviral therapy
I'm certain that Dr Handsfield would say that you don't need more HIV tests at this point with 11 negatives. 
Please let me know what other questions you might have.

Terri Warren
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48 months ago
Hello,
what does a well established HSV infection mean ?
would 14 weeks HSV 2 swab test be accurate ? 
HSV 1 is oral and HSV 2 is Genital, am I right ? can I transmit HSV 1 with sexual contact ?
In regards to HIV, which one increases the risk of getting infected with HIV more ?  and can any of them cause delay seroconversion ? 

Thanks, answers to these questions would really help.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
It means it isn't new in the past couple weeks.
You wouldn't get a swab test at 14 weeks unless you had a lesion, so no, a swab test at 14 weeks of normal skin wouldn't give you any additional information
HSV 1 can be oral or genital - if you have it genitally, it can be transferred via intercourse though that doesn't happen very often and if you have it orally then you could transmit it to others  by giving them oral sex.
HSV 2 is almost always genital.
HSV 2 presents a greater risk of acquiring HIV infecction and no, they don't delay seroconversion

Terri
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48 months ago
Dear Warren,
Thank you for your quick answer.
So saying that, it is possible to have been infected with herpes in my exposure 14 weeks ago, right ? or it has happened before that.
I know the threads are closed following three question but I would appreciate if you keep it open until I meet my doctor tomorrow in case of any issues as I really rely on your expertise in regards to Herpes.
Thanks 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
It is possible that you were infected 14 weeks ago or you could have been infected since childhood from an adult with a cold sore kissing you.  At this point, there is simply no way to know for certain. 
I will leave this open for one more post, then will close it.

Terri
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