[Question #508] Herpes

106 months ago

We are both in our mid 60’s, one man and one woman, and have recently started to date, my girlfriend has indicated that 33 years ago she was told by a free clinic doctor that she had Genital Herpes because of the pimple on her Vulva, she doesn’t remember if there was a blood test, swab or just the visual because at the time she was traumatized.

She has not had an outbreak in 33 years, has had sexual partners and has been married two times and neither husband nor any other man has had symptoms of Herpes or outbreaks.

She has never had a cold sore.

I have had a mild, reoccurring cold sore on my lip once or twice per year since age 20 or so and have never passed to anyone.

What is the likelihood that she actually has Herpes and how does my cold sore factor in to the equation?

We both are crazy for each other and have been holding off on intercourse until the relationship develops. While we both fully understand the ramifications of not using protection, we are not planning on using any form of protection during our intercourse and plan on mouth to genital interaction, obviously great care and diligence will be taken by me not to pass on my cold sore to her mouth or anywhere else.

Will the IgG test tell us what we want to know…if so where in Mpls MN can the test be administered?

Terri Warren, RN, Nurse Practitioner

106 months ago

Hi Michael,
The IgG test can accurately tell you about HSV 2, but it misses one in four HSV 1 infections, compared to the gold standard. I would suggest that you get the IgG test through an online service - I often recommend healthcheckusa.com - they use the same labs that docs routinely do. If you are both HSV 1 positive (and really, if it misses it in you it doesn't matter because you know you have HSV 1 already). then that's great, you both have the same virus. If she is positive for HSV 2 and either positive OR negative for HSV 1 and you are negative for HSV 2, then it would be good for her to take daily suppressive medication for her HSV 2, even though she is not having outbreaks as she is very likely shedding virus from her body, even without symptoms, from time to time and this would reduce the risk of you getting HSV 2 from her. If she is negative for both, then the most cautious thing to do is to get a western blot to see if she has HSV 1. Is that sufficiently confusing? :Please let me know how I can clarify for you.

Terri
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105 months ago

Thank you Terri,

Your response seems clear to me.

healthcheckusa.com offers 232 tests when IgG is searched, which one?

What is the likelihood of her having HSV 2 with no outbreaks in 33 years.

Terri Warren, RN, Nurse Practitioner

105 months ago

She still could have HSV 2, even without outbreaks,yes, I have definitely seen that.
You want HSV 1 and 2 IgG

Terri
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105 months ago

2-25-16

Hello Terri,

Please interpret my girlfriends recent test results from healthcheckusa.com/LabCorp.

HSV 2 IgG, Type Spec163155 Results 3.42 Range 0.00-0.90 Units Index.

HSV 1 IgG, Type Spec164903 Results 52.9 Range 0.00-0.90 Units Index.

You mentioned that someone can have the HSV 2 virus with no outbreaks in 30 years but still can pass it on. This is confusing to me due to the fact that there are no infecting fluids from sores. Please clarify.

Michael

Terri Warren, RN, Nurse Practitioner

105 months ago

Your partner is strongly positive for HSV 1 - has she ever had a cold sore on her lip or in her nose?
She is technically positive for HSV 2 as well. However, her index value falls into the low positive range - 11 to 3.5 and there are false positive in that range. However, at 3.2 she is getting towards the top of that false positive range and is likely, though not certainly, to confirm with the herpes western blot test, the gold standard. What do you mean there were no infecting fluid from the sores? How would you know that?

Terri
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105 months ago

2-26-16

Thanks for your response.

My partner has indicated that she has never had a cold sore on her lips or nose.

If my partner has HSV 2 with no outbreaks in 30 years and did not transmit it to her husband of 10 years, can I still get it from her…and if so how, and what is the likely hood?

I thought that the only way to get it is through skin to skin contact with the sores and/or fluids from the sores during an outbreak.

Michael

Terri Warren, RN, Nurse Practitioner

105 months ago

The thing is, virus can be shed from the body (given off) when there are no symptoms present at all. This is called asymptomatic shedding and we've known about it since 1982. And it's a difficult thing for people to hear about when they have herpes. If she's had no outbreaks in 30 years, that's pretty unusual for HSV 2 but good news. As I mentioned before her test is in the low positive range and if she were my patient, I would be certain she got a herpes western blot antibody test to confirm this as there are some false positives in her range. The odds that you would get HSV 2 from her, if indeed she is infected, are low - if you do nothing at all and have sex about twice per week, the odds that you would get this in a year is about 4%. If she takes daily antiviral medicine, the risk is cut in half. That's a really simple way to reduce the risk of transmission. Also, without an antibody test, it is not really possible to know for certain if her husband was indeed infected. It's a little more complicated than one might think at first glance, huh?

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