Hello, so my question is about HSV II.
A little bit of background one me: In June 2015 I had my first outbreak and it was the worst 2 weeks of my life! It was so painful. I went to my gynecologist who immediately said it was HSV II. She took a culture and the results came back positive. I also had a blood test done the same day to see if I had any antibodies yet, to determine if this was a new infection. My blood results came back negative.
Results were: HSV1 IgG 0.14 and HSV2 IgG 0.49 (I did not have an IgM result)
In November 2016 I went ahead and asked my new gynecologist (new because I relocated) if she could order another blood test for me and explained I had previously tested positive on a culture swab but negative on blood test. I had not experienced any signs or symptoms of another outbreak since my first one. I wanted to see if I had antibodies developed to determine if I was having outbreaks without symptoms. My results came back negative, although some of the numbers were a little higher.
HSV1 IgG0.10 (actually lower) and HSV2 IgG 0.66 and IgM0.89, and these were all just below the "equivocal" range of 0.90-1.09 and "positive" range of >1.10. (negative range was <0.90 for IgG and <0.89 for IgM)
So my question is, it is possible that yes I do have HSV2 because the culture was positive, but I haven't had another outbreak whether it being asymptomatic or not, since the blood work comes back negative? Meaning the virus is dormant so therefor no more antibodies are being developed.
I go to my gynecologist in about 2 weeks and will ask for another blood test, because I still haven't had any symptoms of an outbreak and I'm scared that I'm asymptomatic, which I believe is worse cause then I'll never know when I'm fully contagious and can pass this on to my boyfriend, whom I met after I already had the virus. He is taking the chance, but I still want to protect him as much as I can.

Thank you for any help you can provide.

Hi, I'm glad to see you were able to post your question - I saw your comment that you were "scammed" and called it to the attention of the administrators so glad to see you were able to get this on our forum. 
You said you were positive on the culture, but are you certain that the culture was typed?  That is are you certain it was HSV 2?  HSV 1 can also cause genital infection  and the IgG test misses 30% of HSV 1 and only 8% of HSV 2.  Is there a way for you to check on this?  If the culture was positive, even if it wasn't typed, you clearly have herpes.  Even if the virus doesn't cause skin recurrences, it is active (unless you are taking daily antiviral therapy which you don't mention). 
The IgM is not relevant here. 
So 1) was the culture typed for certain and 2) are you taking daily antiviral medicine?

Terri
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Yes! I received a response to my review and they helped me figure out how I was suppose to post my question!

But, yes the culture was typed. It came back negative for  type 1 but positive for type 2. And I only took the antiviral medications during my first outbreak and maybe about a month after that, then I stopped taking them.

The IgG antibody test misses 8 out of 100 infections - that is close to 10% and you appear to fall into that group.  But if you culture was positive AND typed, then you most certainly have HSV 2.  If you take daily antiviral medicine, it reduces transmission by almost half so that's very good.  And if your boyfriend uses condoms, that reduces it by close to half again.  Has your boyfriend actually been tested to determine that he is not infected?

Terri
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Yes, I am not doubting that I have HSV2, but I'm trying to determine whether or not I've been having asymptomatic outbreaks over the years, which would cause viral shedding and in turn antibody formation to be detected via blood testing (right?). When I get another blood test and the results are again marginal, then it is safe to assume my first outbreak was my only one so far? (not sure how relevant this is, but I also have chronic yeast infections and BV, which I no longer take medication for, because after treatment of one issue, the side effects of meds would make the other occur. So I just live with it now. So after my first herpes outbreak at times I wasn't sure if I was having more of them or not because I NEVER had any sores like that first time. I don't think I could ever forget the pain they caused. I just had, what's usual for me, vaginal discharge and sometimes itchy here and there and sometimes stronger odors here and there as well, but never sores.)

What exactly does the western blot test determine? Am I a candidate for that?

Oh! I forgot to say, no my boyfriend has not been tested for it.

The western blot is another antibody test and would be likely to pick up your infection,but you already know that you have HSV 2, so I don't see how it would benefit you.  All people who are HSV 2 positive shed virus in between outbreaks so there is no question that you are shedding virus.  You don't need to try to figure out if you are having asymptomatic outbreaks - you are shedding.  The Igg test is just missing your infection.  Most recurrences are milder, some far milder, than the original outbreak, so that is very normal.  Also, remember that outbreaks can show up on the buttocks, thigh, anus or abdomen so if you are having symptoms there, they could be outbreaks. 

I think getting your partner test is very important.  If he is also infected, then there is no worry there any longer about transmission.  If he is uninfected, then daily antiviral therapy is something you might want to consider.


Terri
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