[Question #4129] Herpes Exposure Follow Up

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84 months ago
This is a follow up to a previous question that I asked. In short during June and July I had protected and unprotected sex on and off with a woman. There were probably 6 days that we didn't use protection. At the end of June I tested for everything including HSV1 & HSV2, both negative. The last time we had unprotected sex was 19 days ago. The following week she let me know she had tested positive at her OBGYN via IGG blood test for HSV1 and HSV2. Index on HSV2 was 11.90. She knew of the HSV1 as she had previously experienced cold sores in her nose, but not in the past two years. She had never had an outbreak of genital herpes to her knowledge. Her Dr's opinion was that it's highly unlikely she passed it to me. We have ceased having intercourse. I did not experience any symptoms of herpes after initial exposures in June and since last exposure I have not had any signs of an outbreak (I check frequently). I occasionally will see some red areas that go away within a few hours or so, I'd say this is probably due to constant checking. I plan on seeing a General Practitioner for their opinion and doing blood tests with a final one at 12 weeks exposure. That being said given that I was negative before all of this for both HSV1 and HSV2 can I reasonably expect I didn't contract HSV2 with no signs of an outbreak/symptoms at this point? Would someone that is negative to HSV1 be more prone to an HSV2 outbreak after initial infection? 
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Terri Warren, RN, Nurse Practitioner
84 months ago
If you were going to acquire herpes from her,  and were going to get symptoms, they would show up in 2-10 days after the last encounter.  I think herpes here is very unlikely, given that you are 19 days out and have had no sores.  This is particularly true since you went into this relationship being negative for both HSV 1 and 2.  since you have had sex without protection with someone with HSV 2 infection that has been confirmed, I think your plan of getting an HSV 1 and 2 IgG antibody test is completely reasonable - I'm guessing it will be negative.  Please let me know other questions that you might have.

Terri
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84 months ago
Thank you for the information. Given that I’ve been HSV1 negative would there be any value in acquiring an IgM test? I feel like infection is unlikely but it stresses me out that I won’t know anything for sure until 12 weeks with an IGG test. 
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84 months ago
Not to be redundant but I did take an IgG blood test yesterday which came back negative. This was about 3 weeks after unprotected sex and 10 weeks since the second to last time we had unprotected sex. I still have had no symptoms.  I know the recommended timeline of 12 weeks but with no symptoms, being previously negative for HSV1 what’s the likelihood of testing positive down the road? Would 6 weeks post exposure provide a near conclusive result? 
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Terri Warren, RN, Nurse Practitioner
84 months ago
No,I would strongly recommend against the IgM test - it has many many false positives and could really throw you off.
A test done at 6 weeks will pick up about 70% of HSV 2 infections.  And remember that the IgG test misses 30% of HSV 1 infections compared to the gold standard western blot antibody test.

Terri


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84 months ago
One last question. You had mentioned previously my odds were low that I contracted herpes. All things considered should I be confident I didn’t contract?
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Terri Warren, RN, Nurse Practitioner
83 months ago
I believe that I answered this question with the statistics about positivity at six weeks on the IgG test. This is a certain as I am willing to say that you did not contract herpes

Terri.
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