[Question #6664] LGBTQ possibly chronic HSV-1

66 months ago

39 year old lesbian. HSV-1+ Asymptomatic. Doc says I’ve had it a long time or been born with it.

1st blood test. September/2019 (found out I was positive)

HSV 1 IgG, Type Spec Result 52.40 Flag High Reference Range 0-00-0.9 Index

HSV 2 IgG, Type Spec Result <0.91 Flag Normal Reference Range 0.00-0.9

1st cold sore December 2019 after some dental work.

I started valacyclovir. It was gone by Jan 3.

2^nd test was Feb/2020,

HSV 1 IgG, Type Spec Result 49.00 Flag High Reference Range 0-00-0.9 Index

HSV 2 IgG, Type Spec Result <0.91 Flag Normal Reference Range 0.00-0.9

Taking valacyclovir every other day as I want to lower my risk of transmission to my partners.

1. Is there a way to know if I have chronic HSV-1 considering that I have been asymptomatic all my life until recently?

2. Does a high IgG mean that I am currently more contagious (like with an outbreak/shedding) or just that I have the virus?

3. I gave oral sex to my partner about 2 ½ weeks after my outbreak had cleared up to make sure my symptoms had subsided. Is it possible to have given her genital HSV-2 from oral sex? She went and got tested and her doc told her that she has HSV-2 and that her numbers were high. She got tested 3 weeks after we had sex. Can HSV-1 cause genital HSV-2?

4. Are there normal HSV-1 IgG levels? Should I expect my levels to go down as I continue taking meds?

5. Can valacyclovir cause more frequent outbreaks if taken without symptoms?

Are canker sores a symptom of HSV-1?

Terri Warren, RN, Nurse Practitioner

66 months ago

Born with it??? were you in serious medical condition as a newborn, is that why he/she thinks that?

I would agree that you've had this for a while based on your index values.

I'm not completely understanding your question about chronic HS 1. Do you mean since before Sept. when you took the antibody test? Yes, clearly you were infected before then. If you are asking how long you've been infected before that, I cannot say. Is that what you are asking me? I want to be sure I am understanding your question correctly.

A high IgG has no meaning at all except that this is a very well established infection, not new when you tested in Sept but it has no meaning in terms of frequency of viral shedding or likelihood of transmission, no.

HSV 1 stays HSV 1 regardless of its location on the body. It does not become HSV 2. NO. If she has HSV 2, she got it separately from you because from your tests, you don't have it.

These are very normal HSV 1 levels for an established infection, yes, totally normal.

Valacyclovir would certainly NOT cause more frequent outbreaks, no, the opposite.

Canker sores are not caused by HSV 1, no

Terri

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66 months ago

Thank you so much, Terri, for answering quickly. I 've been going through the previously asked questions on this site to get a better understanding of things.

To clarify I don't have any serious or latent medical conditions. I was born prematurely though. I got tested through STDCheck.com via a blood test done at LabCorp. I went to Planned Parenthood to interpret my results. The RN said "Herpes is normal and a lot of people have it. Based on your index it's possible that you could have been born with it but you could have easily picked up from anywhere." It was said in a nonchalant way, not as a diagnosis.

With regard to my question about Chronic HSV-1. What is it exactly? I asked because my index numbers were high and for my lack of knowledge on this subject, I assumed it meant I might have a chronic (frequently reoccurring shedding).

As a follow up on HSV-1 vs HSV-2 is it possible that my high index of HSV-1 is clouding or causing an error in detecting the HSV-2?

I noticed in many of the responses to questions on this site you mention the "Western Blot test as the golden standard". Is there a facility that offers the test on the East Coast or is it only offered at the University of Washington?

And just to be sure I'm understanding you correctly, you are saying the HSV-1 can only transmit HSV-1.

Meaning that if I were to perform oral sex without protection to someone that does not have HSV, that they could potentially contract genital HSV-1 from me.

My GP suggested only taking Valacyclovir before and during and outbreaks. Will my body develop an immunity to the medication if I take it regularly for suppression?

Finally with regard to the current antiviral medications available for the treatment of HSV, acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex),

I've read cases of people reporting an increase in shedding or outbreaks because of a perceived negative reaction to the medications. Is there any truth to this?

Terri Warren, RN, Nurse Practitioner

65 months ago

HSV 1 infection, by its very nature, is chronic. it will always and forever be with you and will periodically be given off from the body, with and without symptoms.

The only way HSV 1 antibody testing impacts HSV 2 antibody testing is very occasionally causing a false positive - never a false negative.

The western blot can be drawn anywhere and sent to the University of Washington. You can work with your own provider on this or I can help you at westoverheights.com

If you have HSV 1 orally, even with no symptoms, there is a small chance that you could infect someone by giving them oral sex, that's correct.

The herpes medication serves to reduce outbreaks and viral shedding, not increase them

Terri

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