[Question #4004] New HSV2 Diagnosis - Primary Outbreak?

32 months ago
I have been recently diagnosed with HSV 1/2. I have a follow-up appointment with my OB/GYN next week to discuss these questions, but wanted to get a second opinion on my situation, and make sure I’m asking the right questions to my doctor. I’m a 36 yo female.

Here’s my timeline:
3/24 thru present – in a monogamous relationship with my significant other, sexually active, unprotected. No sexual activity in 6+ months besides him.

6/19 – I start to experience the beginning of what I now know to be a major HSV2 OB. I think it’s a UTI (painful urination, odor), go to urgent care, they put me on antibiotics (no exam). Over the course of the next few days, my symptoms get much worse, and I also start to develop flu-like systems with headaches and nausea, and overall body aches.

6/27 – The soonest I’m able to get in with my OB/GYN. She diagnoses me on the spot with HSV2 based on description of symptoms and physical exam. She swabs and draws blood. I go on Valtrex. She thinks it is most likely a primary OB based on the severity of symptoms.

Initial Results: – HSV2 Positive (Swab test); HSV1 Positive (IGG – 1.97); HSV2 Negative (IGG – 0.23). They order me to come back in the following week for another round of blood work, and put me on daily Valtrex.

7/11 – Add’l blood drawn. Results: HSV1 Positive (IGG – 2.17); HSV2 Positive (IGG – 9.59).

My BF has never had any symptoms, and has done bloodwork during this time period, but all has come back negative. I’m not sure his exact numbers/tests. He has Chron’s and is on Humira, so insists he would know if he did, but got tested regardless as it seemed obvious he passed it on to me based on the timeline.

Based on the facts above (symptoms + bloodwork) – does this sound like a primary HSV2 OB (which would make it likely my BF infected me and should re-test)? Or could I have been living with HSV2 for some time with no symptoms? I’m guessing my HSV1 could be from childhood, but I have had no known symptoms as an adult.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
I believe that you also posted on the westover heights website.  My response here will be the same.
It does sound like primary infection to me but given how quickly you antibody test was positive, it's very slightly confusing.
Do you know yet if your boyfriend's tests were IgM or IgG results?  Are you able to take  a look at them?