[Question #6151] HSV 2 positive test, no symptoms or outbreaks.
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70 months ago
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Hello doctors,I am a 49/W/F in the USA. I've been with my BF for 3 years, unprotected sex. He was having some weird symptoms (one blister that faded on his shaft), so we both agreed to get tested. I've always asked for "everything" when requesting annual STD tests and never realized that it didn't include HSV in the past. He asked me to request it even though I've never had any outbreaks of any kind. Come to find out I tested positive HSV 2 on the IGG test. The first test was Equivicol and the second was one digit above positive. My BF tested negative for HSV 2 but positive for HSV 1. It has been 5 months that we've known and he will not have sex with me at all. He is totally freaked out about catching it and I'm about to call off the relationship since he can't move past this issue. My questions to you are:1. What are the odds that my blood tests are a false positive since I've never had an ulcer to test it with? 2. My doctor encouraged me not to worry about the number because it is so low and to live my life as I have been and not worry until I get an outbreak. Does this seem like sound advice? This makes me wonder if I start dating someone new that I don't need to disclose this until I start having breakouts, if ever? 3. What are the odds of transmission to my BF? We've been having unprotected sex for so long and he is negative. I've also contacted my last 4 partners and they all tested negatively. 4. Do you have any advice on how to get my partner to be more understanding and stop freaking out about transmission? 5. My last test included HPV and it was negative, however, I strangely started getting either genital warts or skin tags on my vagina on my labia and around the opening of my vagina. The doctor couldn't tell if they are warts or skin tags and suggested I leave them if they are not bothering me. Is it possible to have warts without being positive for HPV? Should I have these treated, tested or removed?
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Terri Warren, RN, Nurse Practitioner
70 months ago
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I need the index value of your IgG test to make an intelligent and accurate response.
But let me say this: IF you are positive (and with what you've said a low positive is likely and may be a false positive) and your boyfriend refuses to have sex with you, that's pretty difficult and not very loving. Just sayin'. However, what you need, if your index value is between 1.1 and 3.5, is a confirmatory test. If your value is in this range, the odds are 50-50 that this is a true positive. If the first was equivocal and the second a low positive, that is concerning for possible new infection. And if he had a blister on the shaft of his penis, that is also concerning. Do you have any worries that he may have had a different partner recently And why did you get tested again?
The HPV issue is also interesting. Warts and skin tags look different from each other. Are there multiple? A biopsy would confirm what they are. And you should probably find out for sure one way or the other.
Terri
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70 months ago
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Thank you for your response. My test result for HSV 2 is 1.22 on the IgG w/Rflx and on the HSV 2 IgM combination test, it was negative. I agree that he is behaving in an unloving manner as he has been distancing himself from me since the test results came in. When I first got the equivocal result last year, he and I had broken up for a month about 7 months prior to testing and we both had a different partner during this time. Since he is negative, I know he didn't contract it and pass it to me. Additionally, I contacted my other partner and he was tested and also came up negative. I really have no idea how long I've been carrying this or how I got it. I'm thinking that unless I get outbreaks, I don't have much to worry about and I may never have one. With this information, what are the odds of transmission? How would I know if I am "shedding"? I have antivirals to take but the doctor told me not to take them unless I am having an outbreak. Should I take these to reduce the odds of transmission? I also contacted my doctor to do a biopsy on my skin tags in my vaginal area to determine if it is a genital wart or skin tag. I just don't understand how I am getting these (appx 6 tags or so) so suddenly but still tested negative for HPV? Wondering if I should test again for it? I did the second test because that is when I started noticing the bumps appearing and thought I was having an outbreak but in fact, I was not. Thank you for your time.
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Terri Warren, RN, Nurse Practitioner
70 months ago
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Oh my goodness. The chance that this is a false positive is 85%. There is just an excellent chance that this is not true. You definitely need a herpes western blot. You can work with your own doctor to get this done or I can help you get it at westoverheights.com, via video consult. DO IT! This has had far reaching consequences (maybe not all bad) and you need to know what the heck is going on here. Try not to take any antivirals, they can influence the test. Let me know what other questions you have.
Terri
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70 months ago
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Thank you for the response. After I had the first result being equivocal, I tested again and then again and both of those results were around 1.22. Being that all 3 tests pointed towards detection of HSV 2, are the odds of the Western Blot test showing a negative result even there? I don't think my insurance will cover the test but I will definitely be ordering it in the hopes of a more accurate reading. I also requested a biopsy on the skin tags/warts that seems to be multiplying. Is there anything I can be doing or requesting from my doctor regarding these? If these are genital warts, should I request a new test for HPV or any other test? It is just weird how these came on so suddenly and I'm worried that these also can spread to my partner if we do have sex even with a condom since they are also on the far end of the labia and will touch his skin during intercourse. Thank you for answering all of my questions.
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Terri Warren, RN, Nurse Practitioner
69 months ago
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With an index value of 1.22, there is greater than an 85% chance that this is a false positive. You should definitely do the blot if you can afford it. I'm glad you requested a biopsy of these skin lesions that are multiplying. Another thing they could be is molluscum contagiosum. The biopsy should give a far clearer answer about what these are. Once you know what they are, you can more accurately manage what to do about them during sex. For example, if they are skin tags, there is no worry about sex. When you say that your last test was negative for HPV, what sort of test was that? To look for HPV, one must do a scraping of the lesions.
Terri
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