[Question #2975] Hsv1 and hsv2 need direction

41 months ago
Hello, 

Ive had hsv1 and have had two cold sores on my lips in my 32 years of life. My husband and i were married. I told him i had cold sores and he said he had had one. He had been tested but they never did an hsv test on him. Since i know its not routine to check for hsv, i asked him to go back to the doctor. Long behold be has antibodies igg for hsv2 and nothing for hsv1. I was tested again and still only have antibodies for hsv1. His only symptoms of herpes has been on his lip, which our doctor said is the infection site.  Ive been told having a prior hsv1 infection can reduce my chances of getting hsv2. We want to conceive what is the best practice to conceive and reduce my risks of getting hsv2? 

Thanks 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
It is essential to understand the limitations of the herpes antibody test. The IgG test misses 30%of HSV 1 infections.  That's a lot and could be your husband. In addition, look at the specific results of the IgG index value for HSV 2. If the number is between 1.1 and 3.5, he needs a confirmatory test to know that he has HSV 2.  Having HSV 1 does not protect you against HSV 2 so if your husband truly does have HSV 2, you are vulnerable.  How long have you been married and having unprotected intercourse? 

Terri
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41 months ago
Prior to the diagnosis we have been having unprotected sex for about a year and a half. We stopped recently trying to figure all this stuff out. If the hsv2 is positive should we assume he has it genitally. We both started taking valtrex 500 mgl to try and prevent sharing the opposite strain to each other. We were planning on having unprotected sex during ovulation times while taking suppression medication and use condoms during all other times. No oral sex at all. We just dont want to miss our opportunity to have a family. 
41 months ago
Ive read some places having hsv in simultaneously places is rare. We are sure he has had an outbreak om his lips but nothing that he is aware of genitally.
41 months ago
Also his hsv2 test was a 7 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
So if his number was a 7,he is very likely infected with HSV 2.  You don't need to take antiviral medicine.  My wild guess is that he has HSV 1 orally and HSV 2 genitally and the test missed his HSV one infection. More than 95% of those infected with HSV-2 have the infection genitally so I think it is safe to assume that he has a genitally, even though the only symptoms that have been seen are oral. If he should get another outbreak on his left, it is important for him to have that swab tested right away and if positive, typed as well.  If he wants to know about his HSV one status, he could obtain a herpes Western blot for clarification. I think it is a reasonable plan to have sex when you ovulate without a condom but while he is taking antiviral therapy. And yes, you are correct, it is not common to have outbreaks of the same type in more than one location. Sometimes, people will have intercourse with and give oral sex to the same person and get it in both locations.

Terri
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41 months ago
Thank you. This is definitely a difficult thing to embrace when talking about a new marriage and beginning a family. However, I am glad we know now so we can be as safe as possible. How long should he be taking the antivirals before we start trying?? 

Thanks for all your help. We are grateful for the education. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
The medicine is fully effective in 5 days.  You know, we all  bring things to relationships that aren't ideal - this is a physical thing but sometimes the non-physical things are far more damaging.  Your graciousness about accepting his situation will endear you to him.  When it's time for him to accept you non-ideal things, I hope he is as gracious.

Terri
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40 months ago
Thank you. We are going to schedule an e visit with you as well. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
40 months ago
sounds good!

Terri
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