[Question #5547] HSV2 diagnosis without symptoms - likelihood of transmission

20 months ago
Dear Dr.  - I am in a monogamous relationship for past 3 years but was active sexually with multiple partners prior for several years. I am a heterosexual male and my partner is female.  My fiance and I abstained from intercourse until marriage, which is coming in 1 month. I promised to get STD tests prior to our marriage, which I just did. Came back negative for everything except HSV2 on IGG test. I have never had any symptoms or outbreaks.  My question is, assuming she is still negative, what is the likelihood of transmission in absence of symptoms, and how is this best managed? Should I take antivirals when we are sexually active ? We plan on practicing NFP , so will only be active certain times of the month.  Thank you for your answers. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
20 months ago
What was the number associated with your positive IgG result?  There are some false positives between 1.1 and 3.5 and if your number is in there, you will need a confirmatory test to clarify.  If higher than that, it is likely that you are infected.  Taking antivirals daily (if she does indeed test negative by IgG test) will reduce transmission by almost half.  Condoms also reduce transmission by 96%

I look forward to hearing back from you

Terri
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20 months ago
Hi Dr. Warren - thanks for your reply. My IgG number was 1.72 so it sounds like it could be a false positive.  What additional test can verify since there are no active lesions to biopsy ? Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
20 months ago
oh yes, you most definitely need a confirmatory test.  There is about a 70% chance that this is a false positive (compared to the gold standard western blot.  And that's the test you need for confirmation.  This test is only done at the University of Washington in Seattle, but it can be drawn anywhere in the US and sent there, but you need to work with a provider to get this done.  You can do this through your own regular provider or I can help you with this at westoverheights.com , the box that says "videoconference".

Terri
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20 months ago
Thank you for this information. Very helpful. I will see if I can coordinate with my provider for a Western Blot confirmation. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
20 months ago
Sounds like a good plan

Terri
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