[Question #4508] What’s my chance of herpes infection?

29 months ago
Thank you for help. I had sexual contact, oral & genital, with a woman I was dating who had a cold sore that had scabbed over and was healing in May of 2016. I thought we had an honest discussion around std’s. She called it a sun blister and tried to act like it was nothing. After some argument she finally admitted she took a 500mg valtrex at the start of symptoms. 
On June 1st went to labcorp and took a herpes IgG blood test. It came back .97 on a range of 0-.90 for HSV-2. I need > 1.09 for a positive result. They said to wait a minimum of at least 2-4 weeks and take another one because it may be too soon.  
In my panic, on June 15th I went to a large top 10  national ranked hospital in the area saw a dermatologist for jock itch and took another herpes test with their lab. My HSV-1 & HSV-2 titers  were not consistent with infection. They didn’t even flag as having higher than normal antibodies. 
I took another Labcorp test on June 30th, more than 4wks since last sexual contact. That test came back .93 on a range of 0-.90 for HSV-2. Lower than my first test
I went back to the large hospital and took another HSV test there on Aug. 2nd. More than 2mos after contact. My test came back negative for both HSV 1 & 2. Per their numbers I was (.2 & .1) HSV 1 & 2. Greater than .8 is representative of infection.  
I have never had an outbreak or cluster of blisters on my mouth or groin. 
Should I take another test? Why the above average Labcorp Numbers? I tried to relax and found I still worry. Please share your thoughts and thanks again for your help. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
29 months ago
Different labs use different brands of antibody tests and those tests have different ranges for their values.  For example, I have never heard of 0.8 as a cutoff for infection at any lab.  But this is probably due to this hospital using a different test brand. 
You are likely not infected, but the IgG tests, regardless of brand, miss 30% of infections compared the gold standard western blot.  They just aren't terrific.  We published a paper with these statistics two years ago.  If you want the best test for HSV 1, it is the western blot.  but if you have had no symptoms and can feel at ease with the negative testing that you have had so far, you certainly don't need to have the blot at this time.

Terri
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29 months ago
Thanks for the follow up.  Your answer certainly helps me feel better. However, it was HSV-2 that flagged a little high, (.97 & .93) not HSV-1. Does this change your thoughts regarding my chance of infection?

In addition, we only had sex twice and it was an oral sore that was healing.  How often do you see oral HSV-2 or people with both HSV-1 & HSV-2? Thanks. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
29 months ago
Well, the oral sore would be HSV 1, almost certainly.  We rarely see HSV 2 orally, especially recurrently - it happens but very infrequently.  Your HSV 2 is still negative though possibly in the equivocal range, depending upon the test brand.  We are talking about an experience more than two years ago!  If you were going to be positive from that experience, I believe you would be positive by now, not equivocal.

Terri
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