[Question #2406] Diagnosed w/ herpes; different web sites saying different things

43 months ago
Hi - I just got diagnosed with HSV (I'm guessing type 2 as it was on my genitals) this afternoon. I'm getting frustrated because different web sites have been telling me different things. My question is: is it possible to pass the virus to someone without ever showing any symptoms? So, even though I recently had my first outbreak, is it possible I contracted it from a partner who has never shown symptoms? And, if so, how do I know how long I've had it for? I'm not sure how likely it is that I contracted this years ago and it has been lying dormant. My provider at an urgent care is telling me that I HAD to have contracted it within the past year at most, but that is impossible because I've had the same sexual partner for more than one year and neither of us have had sex with anyone else. Thanks so much
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
You need to find out the type you have - do not assume you have HSV 2 are most new genital herpes is now caused by HSV 1.  And how were you diagnosed?  Swab test from a lesion?  Blood antibody test?  Is your partner the giver of oral sex to you?  Have they ever had a cold sore?  Have you ever had a cold sore?  It is true that you could have been infected for years and didn't know it OR you could have just contracted it from a partner who doesn't know they are infected.  It is possible to transmit this when a person has zero symptoms.  Has your partner had an IgG antibody test?  It is also important to know your type (1 or 2) so you can compare your results to your partner's results to see if they are the same or different.  If this test was completed 3 days ago, they may still have the sample in the lab and typing may be still done.  contact your provider and ask that typing be performed on this sample, please.

Terri
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43 months ago
Thanks so much Terri. So I was diagnosed with a Swab test from a lesion; they did not do a blood antibody test for it. I just went to a different provider this past Saturday to get two tests: a typing test as well as an IgG or igM test. My boyfriend got tested for these two tests Saturday as well, so we'll be hearing results this week. My partner has given oral sex to me multiple times in the past, and we also do not use condoms. Not sure if he has ever had a sold sore, but I haven't and he hasn't that we know of. I've had partners in the past that I could have contracted it from more than 2 years ago, in some cases where I did not use a condom. So it is a possibility that I could have had it for years, but you're saying it is also possible that my partner gave it to me unknowingly because he has never/does not currently have symptoms? That is basically what we wanted to know. What are next steps in the two scenarios that (1) his test comes back negative and (2) he has the same results as me?
43 months ago
Dear Terri, 

I just got my blood tests back from my hospital visit Saturday and it came back negative. So now I'm super confused. Here is a summary of what has gone on: 

I have had the same sexual partner since March of 2016. He had his last STI screening last spring, which did not show any positives. Neither of us have had another partner since March of 2016. 

I had a swab test done Saturday July 1st which came back positive. This urgent care DID NOT do an antibody test and claimed my blood was "misplaced." and they were "unable to move forward with type testing"

I took antibiotics and the sore was gone in three days. Haven't had anything odd since then.

I got a blood test Saturday July 8 for typing HSV 1 and HSV 2 and a test for IgG and IgM, both of which came back completely negative. What are your thoughts?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
Wow, you situation with urgent care kind of sucks big time - they lost your blood AND they cannot type your sample?  Are they unable to move forward with typing the swab sample?  Or the blood test? 
My thoughts are this:
1) the test missed an established HSV 1 infection - the test misses 30% of HSV 1 infections
2) you have new infection with either HSV 1 or HSV 2 and there has not been adequate time to develop antibody detectable by the test. It can take up to 12 weeks to make antibody detectable by this test and taking antiviral therapy can prolong that time as well.
3) less likely, the IgG test missed an established HSV 2 infection - it misses 8% of infections compared to the gold standard western blot. 

Forget the IgM.  It's a bad test. 
has your partner been tested yet?

Terri
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43 months ago
Yes, my partner was tested Friday July 7 and has not gotten his results back yet. I hear what you're saying about the antibodies taking awhile to build up, but here is my confusion with that: 
I've been with my partner for 1.5 years and neither of us has had any other sexual partners during this time besides each other. That being said, the only possible scenario would be if I had the virus lying dormant in my system for years, however wouldn't that mean the antibodies would have definitely been detectable by blood? From my understanding of my research it takes 6 months at most following exposure for antibodies to show in the blood. This is sort of irrelevant in my case though, because I have not had exposure to any other sexual partners in over 1.5 years. I called the original urgent care I went to telling them that this blood test was negative, and they were far from helpful. They started giving me information that I knew was wrong and I was correcting the nurse over the phone.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
So the other scenario is that your partner has been infected for years and didn't know it.  Right?  and you can be together for years before transmission happens. 

Terri
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43 months ago
So if I'm understanding correctly, you're saying it is possible that my partner has had the virus dormant in his system for years, and even though we've been having sex for 2 years, he may have just recently transmitted it to me in the past 6-month time frame? So you're saying that I could have had immunity against his virus for the first 1.5 years of having sex with him? This would make sense because again, the only possible way my blood test came back negative while I actually have the virus would be if the antibodies did not show up yet. Can't figure out how I could have possibly had a negative blood and a positive culture since culture is more reliable.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
It is possible that your partner has been infected for years and just infected you, correct.  It is also possible that you've been infected for years and the test missed your infection.  The way to try to make that distinction is for you to repeat the antibody test in 6-12 weeks and if it is positive, that means that you just got this infection - your body made antibody in response to the infection.  If your antibody test remains negative, then this suggests that the test is missing your infection.

Terri
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