[Question #467] Transmission questions

33 months ago

I am a 47 year old woman, tested positive 7mos ago for HSV 2 (negative for 1). I've been having weird genital symptoms for 7 mos as well and no one can say for sure if the symptoms are related to the virus.  Have met with 2 different doctors and also "spoke" through this site with Teri Warren.  I have never had an outbreak in my life.  I have decided to try taking an antiviral for 2 mos. as my doctor thinks if the symptoms go away then they would In fact be related to the virus, although I tried this (and many other things)  b4 with no success.  Anyway my questions are related to the likelihood of transmission to a partner.  I understand that if these are Herpes related symptoms I could infect a partner, I also understand that If someone infected is unknowingly shedding the virus (with no outbreak) they are contagious. So my questions are that if either of the above scenario applies to me (virus related symptoms/shedding) and there is no outbreak......

1-would someone be at risk for performing oral sex on me?

2-Is the risk of transmission with any skin to skin contact of the genitals with my partner or only with penetration?

3-When I tested 7 mos ago my index # was >8.0.....I tested again last month and it was >5.0 is there any significance to the lower # with the 2nd test?

If I have asked to many questions I am happy to pay more.  Honestly I feel as if my life has been completely ruined and I just want to know to what degree.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
Welcome back, Maria.  I think if the symptoms don't improve with antiviral therapy, they are unlikely to be caused by herpes.  Also, herpes symptoms are not continuous, they are intermittent.  I think a most accurate assessment of the opportunity for transmission is that there is a potential for infectiousness at any time - with or without symptoms, and so it is best to behave as though that is the case, with or without these symptoms.  So in essence, in your case, unless you have a specific sore or outbreak, you should behave as though you are in an asymptomatic period. 

1.  There is a small risk of transmission by someone giving you oral sex - definitely not big - really small.  And if they did get HSV 2 orally in this way, they would be really unlikely to recur as HSV 2 does not like the mouth and it would essentially vaccinate them against genital infection.
2.  Genital to genital contact is the risk.  So penis to buttocks is not a risk, penis to thigh is not, penis to belly is not, penis to labia without penetration is a risk
3.  The numeric difference is not significant, no, not at all.

Whether your life is ruined or not is totally up to you, Maria.  So let's talk about transmission risk.  If you take daily antiviral therapy ( 400 mg acyclovir twice a day or 500 mg valacyclovir once a day) and your partner uses condoms regularly and you have sex about twice per week (more sex, a bit more risk) and you avoid sex during outbreaks and you have disclosed your herpes to your partner, about one man out of 100 will acquire herpes from you in a year.  Those are averages.  Will you allow your life to be ruined using these numbers?  I surely hope not!
This is only aspect of who you are, not all of you!  I do hope you will attempt to think differently about this and decide instead of your life is ruined that instead, your life has changed - in this one aspect and there is now a new normal.  You can do this!

Terri 
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33 months ago

Thanks for info & words of encouragement.  The thing is that this makes absolutely no sense to me.  If I had not been paranoid because I had been with a man who developed a "cold sore" 2 days later, (he has since tested positive for type 1 and negative for 2) then I started having these weird symptoms.... I would never had gotten tested for herpes and I would never have known because I have never had any indication that I had/have herpes, (unless these current issues are herpes related, which seems unlikely).  This tells me that it is possible I have been carrying this virus (with out transmitting to my husband of 23 years or the man I was with) since the age of 18 when my now ex husband and I "got together" with another couple.

Anyway....I do have another 2 questions...

On my lab reports the section that reads Herpes 1/2 IgM  shows positive...index with the first test was 1.16 and with the second test 1.51.  One doc told me this indicated an acute result (I guess meaning recent exposure) and another doc told me it indicated exposure a long time ago.  What does it mean?  I have not been with anyone between the first and second test 7 mos apart so acute exposure would not make any sense.

Last question...regarding the medicine I am now on (Valacyclovir 500mg twice/day) to see if it clears my current symptoms. She wants me to do 2 months of it.  If it is going to help how long b4 I should notice improvement?  Have been on it 2 weeks now.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
You cannot know for certain if your previous partners are infected unless they have an antibody test - they could have, in fact, infected you.  Perhaps you do know that they have had an antibody test and are negative. 
The IgM test is inaccurate in several ways - it has many false positives AND can be present with recurrences.  It is very unreliable.  With in index value of >8, you do NOT have new infection.
I would give the valacyclovir a couple of months - one would expect improvement of symptoms within a month if these symptoms are related to herpes - they may well not be.

Terri
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33 months ago

Thanks Terri

I guess what I am trying to figure out is how long I have been carrying this virus/where I got it...I have literally been with only 4 men in my entire life. 

--One at 18 y/o (who gave me vaginal/cervical warts (condyloma-??) which I had to have cervical laser surgery to remove)

--My ex husband of 23 yrs. (whom I am fairly certain does not have herpes),

--one who I was with in Dec 2014 (6 mos prior to my first positive test)

--the partner I have been with on/off since my divorce 5 years ago (this man tested positive type1 & negative type 2). 


So being as both of my tests are positive with high index on the IgG for type 2---and positive IgM with >8 result (you mentioned this would not indicate recent exposure), does recent mean a few months, year(s), ??

Could all of this mean it is likely or possible I have had this since 18 yrs old? 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
Maria, I know you are searching for some real answers here but unfortunately, the only person we can rule out here is partner number 4 who we know is negative.  Remember that 80% of people who have herpes don't know it, so your ex husband could be infected and not know it and either of the other two.  The partner who gave you HPV might be a possibility as he already had an STD.  So yes, you could have had this since you were 18 and just didn't know it.  And we have had one person who tested at >5 on the screening test who did not confirm as positive on the western blot.  I am not encouraging you to get that test here but I am saying that a false positive is a possibility.
I didn't realize that the >8 was an IgM test, not an IgG test - please pay not attention to that test - it is clearly faulty.  It is the IgG that you need to recognize. 

This is your final post on this subscription - if you have other questions, please feel free to renew.
Best
Terri
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