[Question #5699] HSV1 Exposure

21 months ago

Recently, in the past few weeks, I met a guy who assured me that he had been tested for everything and was all clear for stds. I have not engaged in activity (e.g. kissing, touching, oral, vaginal, heavy petting) for 10-years, so I was pretty certain, that my tests during that time were accurate, just in case, I did take on a partner. My results indicated that I was negative for everything.

Well, we have engaged in unprotected oral (giving and receiving), on several occasions, fingering and passionate kissing, and genital rubbing. We both shared our most recent results (the end of 2016 for me and beginning 2017 for him (he had more recent results but that was in paper form and he had no access to that), after we started engaging in activity, while my tests included HSV1 & HSV2; unfortunately, his only included HSV2 – he was under the impression that he was all clear because his care providers told him so, even though he paid extra expecting to be tested for everything. Apparently, this is quite common and he was only tested for HSV2.

Well, our most recent encounter was on July 5th, I tested for everything on July 7th, my results came back negative for HSV1 and HSV2 a few days later, he tested some days later and now knows that he has HSV1. He has had no history of symptoms – his index value of 1.22 indicates a possible recent infection.

In the past week, I have been experiencing mild burning/tingling around my vaginal opening, above my buttock (in the crack region), back of my thigh, labia, and some tingling around my lips. We attributed that to a water-based lube that we used, as well as the nurse we spoke to after his results.

As expected, I am terrified. I know there’s no information about transmission rates for HSV1, but how likely is it that I would contract HSV1 from these interactions? Also, when should I get tested again to know for sure that I am negative for HSV1?

*HSV1 testing was done using IGG for both him and I*


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
Well, my first question would be when was the last time he had contact with someone else - kissing and giving oral sex. 
The index value of 1.22 could mean one of three things - 1) this is indeed new infection and so the timing of his last contact would be important, 2) it is a false positive - it is indeed a very low positive and false positive certainly happen with both HSV 1 and 2 and 3) he is positive (as is half the population) and he just has a low index value which by itself has no meaning.  As for you, the IgG test, compared to the gold standard western blot from the University of  Washington, misses 30% of HSV 1 so you could also be infected and your test missed it.  I would guess that the burning you feel is not related to new HSV 1 as it is very generalized in location and you have no lesions. 
Let me know when he was last with someone please.

Terri
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21 months ago
1) I believe his last sexual contact was in March.
2) What are my steps going forward, should I wait 12-weeks as I have seen suggested, on this forum
3) Upon retest using IGG, is the likelihood of a missed positive test still 30%? How about for HSV2? Is the test reliable for HSV2?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
1) so his HSV 1 antibody score is NOT due to new infection - if he contracted this is March, he would likely have a higher index value now.
2) for an accurate test, you would need to wait 12 weeks. 
3) Yes, in my experience, if it misses it once, it misses it multiple times.  It only misses 8% of HSV 2 compared to the gold standard western blot

Terri
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21 months ago
1. So we do not live in Washington State, how will we go about getting the Western Blot, to confirm our results? 
2. Just for clarification, does a low index mean new infection, or an older infection? Theoretically, one should have more antibodies over time, correct?
3. For now though, should I wait the 12 weeks, then if positive, request the blot? If I'm negative of IGG again, should I stress over this with no symptoms? 
4. I've seen mentioned that symptoms of a new infection, appear within 2-20 days, with an average 5.5 days to present. I am now on day 10 with no vesicles, or lesions on lips or genitals.

Again, thanks for your expertise and time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
You can work with UW even if you don't live in Washington, and you can do it either through your own health care provider or through me with an evisit at westoverheights.com (video consult). 
A low index value could mean 1) a false positive 2) a new infection or 3) an old infection and you just have a low value as your value
You should wait 12 weeks before requesting the blot, yes.  The IgG test misses 30% of HSV 1 and 8% of HSV 2 so you can decide how comfortable you are with those statistics.
Good that you have had no symptoms during that time frame.  I suspect that now, you won't.

Terri
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