[Question #6018] Do I need more testing?

17 months ago
I am a male who recently  ended a relationship with an hsv2+ female. Previous to the relationship I was positive for HSV1 and negative for hsv2. I tested negative for hsv2 via quest Igg six weeks after we broke up. For about six months at the beginning of 2018 we had unprotected sex and then the past year she was diagnosed by bloodwork (igg >5) and she took Valtrex and I wore condoms. 

I never had specific symptoms but did have itching and burning after reading those could be symptoms. My legs and feet have also ached. 

My doctor did not believe more testing was necessary. Should I consider my self negative and move on? Or do I need more testing. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
The current thought is that a final test should be done at 12 weeks post final exposure.  The fact that you were negative at 6 weeks means that there is a 70% chance that you will also be negative at 12 weeks, should you decide to do that.  The IgG test picks up 92% of HSV 2 infections, compared to the gold standard herpes western blot.  The fact that you have had no symptoms, other than those that you describe.  I think it depends upon how much certainty you feel comfortable accepting.  If you decide that you want the most accurate test for HSV antibody, you will chose the western blot.  If you decide that no symptoms, combined with a negative IgG test is adequate, that's OK too.  How do you feel about the percentages?

Terri Warren
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17 months ago
Terri,

Thanks for the info.  A couple follow ups 

1) in your experience, are those who are falsely negative more likely to be asymptomatic than those who accurately test positive? 

2) how reassuring is my lack of lesions? I did have one bump in the crease of my groin that I was able to squeeze and pus came out of the head. Does that sound concerning? 

3) I read that chances of transmitting in our scenario (when she was unaware of her status) were about 5% a year. am I correct that my risk of being positive by blot is approximately 1.5% (30% chance of false negative multiplied by a 5% risk of acquisition) 

4) how comforting is my lack of traditional symptoms? I have explicitly looked for them following her diagnosis, but did not look during the first six months or so as I didn’t believe there was any risk. 

5) if I were your patient (I’m aware we have no provider-patient relationship via this forum), how would you advise me to proceed?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
1.  I don't have information about that question, sorry
2.  It is reassuring, but balance that against the fact that 80% of those infected with HSV 2 are not aware of their infection status.
3.  I'm not sure about that calculation but it seems OK
4.  See the answer to question #2.
5.  My answer to this question has to be individualized by the level of anxiety that you have about this and the level of certainty that you desire.  For some people, an 8% miss with no symptoms means they arent' going to worry about this.  For others, even a 5% miss rate is way too much.  I guess I would say if money is NOT an issue, I would do the blot but if money is an issue, and you have no symptoms, then you can feel largely reassured.  I wish I had a clearer answer but everyone is just different in their need for clarity

Terri
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17 months ago
Thanks Terri, this service is a great resource. Based on this I will pursue the blot.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
sounds like a plan.  You are most welcome

Terri
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