[Question #2146] Test results

47 months ago
Good morning Terri, 
I received my test results and after all of the valuable information you've given me, I find there is just one I have left. 
To recap, I had two IGG blood tests in the past. One in 2013 and another in 2014. The results were as followed for both. 
HSV1 >8.0
HSV 2 <0.2

As previously discussed, I had cold sores since I was 13, therefore I expected a positive HSV1 test. 

I received my PCR swab for HSV and it read "Non isolated" therefore it was negative. I did ask for a blood test as well, because I wanted to ensure the negative results weren't due to an absence of symptoms. Now, I have had one recent sexual partner since my last blood test in 2014, and that is my current boyfriend who already had cold sores as well.  Here were my results. 
HSV 1 >58.4
HSV 2 <.05 

I am aware I am negative for HSV2, but what I am wondering is why my HSV1 index has increased so significantly. When I was first tested in 2013, my index was >8 and that was after a 9 year history of cold sores. I am confused as to why after another 3 years the index would increase that high after having had no sexual partners since 2014 except recently with a partner whose HSV1 status is the same as my own.

I began worrying that perhaps my original test index (2013) was low because I was recently infected by a sexual partner- but that cannot be true, as I was clearly infected with cold sores years before any sexual encounter. 

Some facts- Wednesday  May 10th I was swabbed for PCR. Had no symptoms, simply some razor bumps and discharge with no odor. 
Thursday evening , May 11th I noticed some pink, patchy irritation on my inner right thigh and lower buttocks. I took photos of the area and scheduled a follow up appointment with my GP. The irritation was gone the next morning, but since I've been taking. Valtrex that was of little comfort to me as I know the medication can stop outbreaks quickly. The GP Friday May 11th looked at the photos of the irritation and said it was not herpes and also confirmed t
47 months ago
Sorry, my browser froze, this submitting when I wasn't finished my question. 

She also confirmed what you said about having antibodies to protect me from getting HSV1 genitally and to stop worrying about it. 

So in conclusion, I am wondering what could have increased my index level so considerably. I have been taking valtrex  for a month consistently, and I also did have an a ACcute, tiny cold sore inside my nose two weeks prior to this blood test. Would that have any affect? I guess my concern is still that there is some way for my to have it genitally- despite the knowledge I have about how unlikely that is. I appreciate your opinion of these increases immensely. Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
Jennifer, I think that there is no reason for concern at all.  It looks to me like either you used a different lab to get tested the two times OR the lab switched tests.  I think you are comparing apples to oranges and this is not a cause for any concerns at all.  Different tests have different ranges for positives - some go far higher than others and if the first result was >8, it could have been as high as 58 and they just didn't report it out if it is above 8.  That is another common lab practice.
Does that help?

Terri
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47 months ago
Yes, it helps me tremendously. Thank you so much for clearing this up. I find that I put my mind at ease, only for another concern to arise that I become fixated on and worry about. I have found myself thinking back to any time I experienced redness, discomfort, itching etc and wonder if is was a possible outbreak of something more. Knowing I am negative hsv2 and have no reason to worry about hsv1 genitally, I realize that that is most likely not the case at all- seems like I have some anxiety coping strategies to master. 

One final question before I put all this behind me. I take Valtrex daily for cold sore suppression and to reduce shedding. You said since my bf has cold sores it is unlikely I will infect him genitally, so might I stop taking the Valtrex daily and switch to episodic treatment? It's been hard to allow myself to stop the treatment because I don't want to stop and increase transmission risk. Having said this, if I do not take Valtrex daily and avoid oral to general contact during visible signs of outbreak and knowing his history of cold sores, is it safe to say I can engage in a normal oral- genital sex life without concern?  

You truly have been very patient with my questions and I am very grateful for your knowledge and the existence of this forum. Thank you again for everything. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
You can certainly stop your Valtrex if you are both infected with HSV 1 only.  Do you know that he is HSV 2 negative and has no other STI's?
You are most welcome, Jennifer - happy to help you.

Terri
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47 months ago
I know a few years ago he tested for all STDS (with the exception of HSV-which was not included) and was negative. We only know he has HSV1 due to the fact he has also gotten cold sores since he was a teen.  In our discussion, he said he never has experienced any kind of genital outbreak. I know, of course, this does not mean he is not an asymptomatic carrier; however, he seems confident given his sexual history and low number of partners that he is not infected, so I am not overly concerned. Since I confidently know my own HSV status, I know that should I acquire HSV2 in the future, it will be from my current partner and we will again have the same virus. That being said, should I continue the valtrex due to NOT knowing his HSV2 status? I do not believe, given your other posts, that taking valtrex keeps you from acquiring infection. 

My main worry through all of this has been whether or not I have HSV1 genitally. I have of course had BV, razor burn, redness/ irritation in the past (as most women do) so learning that the antibody test only confirms infection and not location truly sent me into a spiral and overwhelmed me with the thought that I could have it genitally and not know. 

So to be 100% clear from this point on-
1)  it is your professional opinion that I need not worry about having HSV1 genitally. 
2) Even if I slept with someone who had hsv1 genitally and didn't know it, I still shouldn't be worried because I have already been infected orally years before sexual activity. 
And 3) My boyfriend and I cannot infect each other genitally through oral sex since we have HSV1 orally already.

I will certainly sleep soundly from your responses. Have a wonderful rest of your day!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Knowing his HSV-2 status has nothing to do with you taking Valtrex. For example if he did have a HSV-2, it would not help you to not get herpes by taking Valtrex. If he has had cold sores since he was 10 years old, the chances that he would have HSV one genitally are exceedingly low.

One. Correct I don't think you need to worry about having HSV 1 genitally.
two. Correct
Three. I never say never, but I think one of you acquiring this genitally after having it orally is extremely unlikely

Terri
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