[Question #4065] HSV-2

32 months ago
I am a little confused about Genital Herpes and hoping for some clarification. I want to make sure i'm practicing safe sex and being responsible to my partners. 
1. Genital Herpes antibody tests have a high false positive rate, correct?  I've been tested multiple times in the past few years for it as it was a grouping among other STD tests (safe sex practices) and all were negative, thankfully (I didn't know about high false positive tests). Does that mean the false-negative rate is also high? Or does that not matter and a negative antibody HSV-2 test is reliable and can be certain you don't have, nor ever had it?
2. I was told that if you were exposed the physical signs would show up in 10-12 days after exposure (blisters, etc..)? Someone else mentioned it can remain latent and show up later? Those are contradictory to me, hoping for clarification there as I was told people would have multiple outbreaks and it would be obvious.
3. I get irritation to my foreskin, near the tip and can create redness there and along tip of penis, sometimes head of it. This usually occurs if I have been camping for a while (few days without cleaning) or sometimes after flying, or after a weekend of drinking a bit too much. It seems to be connected around moisture and if I don't properly stop urine completely that happens when flying, etc.. I've never observed blisters, sores or anything like that. It occasionally will cause pain when retracting foreskin. I believe that's called balanitis? I have oral cold sores and so it looks nothing like those, nor feels like it. Does genital herpes appear like cold sores? 
4. In summary, I want to make sure I'm practicing safe sex and not a threat to someone else so knowing if those negative tests are accurate and reliable as to myself not having genital herpes, and that I've never noticed anything like them if I understand them correctly (what web md says, and if they look like and feel like oral cold sores). 
Thanks so much. 

32 months ago
Also, I know you can get oral herpes (cold sores) from kissing someone, but you can't get genital herpes from kissing someone right? Even if they performed oral sex on someone who had genital herpes recently? Virus doesn't transmit from gential to lip to another person's lip, per se? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
1.  It is not true that there is a high false positive rate for HSV  antibody tests.  About 6% of people who test for HSV 2 get results in the low positive range, 1.1 to 3.5.  This is where the vast majority of false positive occurs.  About 50% of people who test in this range have a false positive result.  The traditional IgG test misses 30% of HSV 1` and 8% of HSV 2.
2.  IF someone is going to have symptoms with a first infection, they normally show up 2-10 after infection.  But not everyone with new herpes has symptoms, particularly if they have HSV 1 already. 
3.  Genital herpes does look a lot like a cold sore.  What you describe does not sound like herpes to me but I can't be certain.
4.  You can't get genital herpes from kissing someone, no.  If someone gives oral sex to someone who has genital herpes, there is a small risk of getting it on their mouth, is that your question?

Terri
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32 months ago
1. Ok, so much more accurate than some people understand- HSV-2 misses 8% per test, so multiple tests would decrease that percentage of missing anything substantially?
2. And, sorry, that was 2-10 days after, or month? Not every person who has HSV-2 has symptoms if they already have HSV-1- rather rare? Do they eventually...How long does it take typically? but that would still be picked up on HSV-2 antibody testing anyway, right?
I guess I just kinda would like to know that some partner I had 6 months or a year ago didn't give me HSV-2 and isn't going to all of a sudden show up with a sore, despite being tested multiple times and showing negative results.
3. Thank you
4. Yeah, sort of, I guess I was wondering if it could be transferred to a third person if person 1 could get HSV-2 on their mouth from person 2? Essentially, If someone gave oral sex to someone who had genital herpes and then had it on their lips or something, and then a little alter on kissed someone else, would the latter person get genital herpes? But basically, you can't get genital herpes from kissing is what you stated. 
Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
1.  Often if the test misses it once, it will miss it again.
2.  Days after, not months.  some people who get HSV 2 while having HSV 1 will never have symptoms, but yes, will test positive on the antibody test
3.  You're welcome
4.  That's all a bit of a stretch as HSV 2 does not like the mouth and when present there, rarely sheds.

Terri
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31 months ago
Thank you for that. 
You mentioned that if it misses it once, it may miss it again? My doctor had mentioned that the false negatives were usually because the test was performed too early and it would miss it there and obviously if missed there, it would miss it again if done too soon again. He said that if I have four negative tests, that it was certainly conclusive I didn't HSV-2. 
You said if someone is going to have symptoms with new infection they normally show up 2-10 days after infection, but if have HSV-1 they may never have symptoms? 

I've never had symptoms of HSV-2, I was hoping I had done enough with four negative tests to be as certain as possible that I am in the clear. It's been 8 months since any sexual encounter for me. I just don't want to have it and pass on to someone, so hoping that I'm good to go. 

Thanks so much
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
31 months ago
Your doctor is partially correct, yes, if you test too early you can get a false negative but it also happens just because of lack of sensitivity of the test itself.
Yes,sometimes people with HSV 1 particularly do not demonstrate symptoms when they acquire HSV 2.
There is a 92% chance if you have HSV 2 that the test will pick it up - that's pretty darn good,would you agree?  If you want more certainty, you could obtain the western blot from the University of Washington .

Terri
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