[Question #2151] WORRIED HSV2

47 months ago
Hi, Thanks for taking my question.  I had a latest possible exposure to hsv2 5 weeks ago.  That last encounter about 12 hours after having sex so told me she had herpes 2 and was having a flare up on her buttocks.  We had vaginal sex from that "behind" position 12 hours earlier.  She wasn't sure but outbreak could have been there at time of sex.  Over the next few days I had weird body sensations from bugs crawling, tingling, (bubbles), muscle twitches and sore numb tailbone.  They were mostly all lower body region groin, scrotum, thighs, calves and feet but I did have some numbing sensation in my hands from time to time.  The lower body sensation are constant (every day for 5 weeks) but mostly felt more at night and worst after waking up from deep sleep (those sensations start immediately and are most pronounced).  I was blood tested at 4 weeks 5 days after last exposure.  My results:HSV1 <.1   HSV2 .12    IGM .49  My questions:1.  Since my IGG test are so low but my IGM is .49 could that mean I will test IGG positive in future?  MY hsv1 is slightly higher than my current hsv2 so that may be trending upwards as I develop antibodies but if that is the case wouldn't I test positive for IGM?  I had chicken pox as a kid.  2.  What are the odds of transmission from above scenario with condom assuming she was having an outbreak or did shortly after having sex?  3.  I know my body and just don't think this can all be a coincidence with all the nerve issues I'm having.  I had a few bright red pin sized dots in public region about a week after this encounter.  No sore or itching or pain.  They went away in about 5-7 days.  Those dots came back again about 3.5 weeks later in same general area (maybe a inch away) and stayed for about a week.   Could that be my herpes outbreak with never being exposed to HSV per test?  4.  Since no prior exposure to HSV wouldn't may outbreak be bad?  Could this explain all the Nerve issues?  Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
1  A blood test done 4 to 5 weeks after an encounter Will only give you a baseline value. That is way too soon to know anything about whether you got infected at that encounter or not. It will only tell you if you were infected prior to that encounter or not. The IGM test is very poor and cannot be relied upon with either a positive or negative result.
2 we don't have exact information on the risk of acquiring HSV-2 in that situation but given that you used a condom, I think the risk is very low with a single encounter.  Your partner may not understand that even though her outbreak was on her buttocks, she may still shed virus from the genital track.  Even though I'm sure you are aware of your body, I think transmission in the situation is quite unlikely. It's hard for me to envision your red dots but from what you said, these do not sound to me like herpes lesions. If indeed you have never had HSV one or two, I would expect a more noticeable first outbreak. The problem here is that the igG test for herpes type one misses 30% of infections compared to the gold standard herpes Western blot.

Please let me know what other questions you may have.

Terri
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47 months ago
If I retest at 8 weeks then 12 weeks, etc.  and IGG number is rising but still negative would that assume a positive result may happen or is there a  discrepancy between tests and a negative means a negative?    Thanks
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
If it is negative at 12 weeks, then a negative is a negative.  Try not to pay too much attention to the negative index value at 12 weeks  If you had  high negative at 4 weeks, I might be concerned but not at 12 weeks.  Is that what you mean?

Terri
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47 months ago
Thanks,  Just to clarify I mean that at 8 0r 12 weeks for example I test .3 or .5 or .7 for Hsv2.  That index value jumped considerably from .12 so I guess I'm wondering if the index value increasing but still in negative range means I am seroconverting and should get retested at 16 weeks or 6 months just to make sure.  Since my baseline is .12 should I test close to that number each time or once again  is a negative a negative and index value really doesn't matter as long as its negative.  I also have a clarification question  I saw on another post of yours that about 50% would test positive at 3 weeks and 70% at week 6.  I only had 2 encounters with this person and the first encounter was 1 week prior(protected).  so I am 4.5-5.5 week range for blood test at this point with a low negative.  Is that a good sign  or am I just as likely to test positive in the future?  If index value is still close to the same number at 12 weeks would you recommend getting tested again at 16 weeks or as far out as 6 months?  Just in case what timeframe is  best  to take western blot?  Is the Western Blot also better at picking up HSV1 since I was negative on this test?  I appreciate your help!  Thanks again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
47 months ago
From my experience, a negative is a negative at 12 weeks.  If it was climbing earlier than that, say close to .7, then I would be paying attention, yes.  I'm not sure, but it looks to me like you are comparing the index value of your IgG to your IgM, is that right?  They are completely unrelated!  Since each test is compared to a different control sample, I would expect them to vary some.  It is a great sign that you are a soundly low negative at this time.  If your index value is still low, you don't need to test again after 12 weeks.  And again, NO IgM TESTING!  Many false positives and all experts agree that it should never be done.  The western blot is far better at picking up HSV 1, yes - an additional 30%.  The western blot can now be done at 12 weeks.

Terri
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