A leading sexual health clinic confirmed genital HSV 2 by swab test 4 to 5 years ago. However, multiple ELISA antibody tests over subsequent years were in clear negative territory including as recently as a few months ago (the test index value U/ml was higher than in a test conducted before the swab confirmation, but far from the subjective threshold). Recurrent outbreaks were very minor and I think 2 in number. The initial outbreak itself appeared to affect a small area (5mm by 5mm) and I recovered rapidly; some medication was prescribed (I forget which) to hasten the recovery.

The traditional IgG test misses about 8% of HSV 2 infections, compared to the gold standard herpes western blot, so I'm not shocked that your infection was not picked up by the IgG test.  But lack of serconversion by IgG does not indicate lack of antibody - it just wasn't picked up by the test that isn't terrific.  This has no impact on transmission.  The fact that you have infrequent recurrences does suggest that you shed virus less often than someone who has a more typical recurrences pattern, 4-6 per year.  The fact that you are five years out, vs. 6 months our or even two years out, also suggests that you are shedding less often than someone with brand new herpes. 
The test accuracy also applies to your partner (the IgG test misses 30% of HSV 1 infections).  But assuming for a moment that she is truly negative, you best bets for reducing transmission include daily antiviral therapy (either 500 mg once a day of valacyclovir or 400 mg twice a day of acyclovir), absolutely consistent condom use with every intercourse,  you telling her about your infection and you being aware of any prodromal symptoms and avoiding intercourse when you have them and obviously avoiding intercourse with an outbreak, even with condoms as they do break or come off from time to time

Terri
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Terri,

I think the multiple studies examined lots and lots of people with varying duration of infections.  Your statistics are correct.  Those statistics are based on intercourse about twice per week - more sex more risk, less sex, less risk - which makes sense. 

Terri
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Thank you again. I also had a question about being apparently twice infected with genital HSV 2 at different points in time and the implications of this. I submitted it as a new question, but just saw this may exceed my 6 month quota. Perhaps you could answer in this thread if all possible.

NO!

Terri
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