[Question #669] hsv 2 (update/follow-up question)

53 months ago
Hello again,

I have follow up info and could use some help understanding/applying it to my situation (I'm assuming you can find my previous post under the same username?). Nothing has changed regarding the situation (no more encounters) but I have more specific test results from the partner of concern. He is hsv 1 and 2 positive. The hsv2 test done was igg. The result was 1.6. My understanding is this falls into a low positive category but I'm not sure what that means for me and my hsv2 risk (I already test positive for hsv1) from my 3 encounters (broken condom encounter plus two condom protected). Any insight would be helpful here. Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
53 months ago
You are correct - his IgG is in the low positive range and at that index value, there is about an 80% chance that this is a false positive.  It would be very helpful for both of you if he had that result confirmed by western blot antibody test.  We are currently doing a study comparing western blot and ELISA (the test he had done) at our website, westoverheights.com or you could contact the University of Washington directly about the test for him but I would strongly encourage him to get this confirmation.

Terri
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53 months ago
Hi again,

Checking back to assess current symptoms of potential hsv2. Further risks to consider I did not mention was unprotected oral sex given/received in addition on one unprotected (condom broke) sexual intercourse on March 18, unprotected oral received/given March  24 and March 25, both days with breif protected intercourse. Nothing since. Two weeks ago stared to feel headaches. Last few days have bad headaches, chills, fatigue, sharp short-lasting pains in the arms and hands and legs. I checked my fever a couple of times and didn't have but can't say for sure that's true of all of the last 2 weeks. Now notice bumps near the clitoris. They don't hurt when touched, feel hard when pressure is applied, and resemble bumps elsewhere on the lips. I saw a gynecologist (not my regular one) for assessment/swab. I await the results. She wasn't sure what to make of the bumps and said it didn't stand out to her as herpes ulcerations but obviously she couldn't be sure. I was wondering your take on my symptoms as suggestive of primary heropes outbreak.  My partner has not agreed to western blot but now says he seems to have a potential outbreak on his chin, which could've been him passing it to me genitally and then back to himself orally, if his initial hsv2 diagnosis, assuming accurate, was in his genitals. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
53 months ago
Whether the bumps near your clitoris are herpes or not is best assessed by your clinician, for sure.  Most often, I would say that herpes lesions, when pressure is applied, are at least tender.  Did she take a swab of the bumps?  It would not occur that he would pass it to you  and then back to himself orally.  But if he is HSV 1 positive, then it would not be surprising that he could have an outbreak on his chin.  And if he has oral HSV 1, and was the giver of oral sex to you, then he could transmit this from his mouth to your genitals.  But we don't even have any idea that you have herpes at all, right?  Or that these symptoms are herpetic.  And we don't know if he has HSV 2 at all.  There are many unknowns here.  Herpes would not cause short lasting pains in your arms and hands.

Terri
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53 months ago
Sorry Terri I was under the impression you could reference my first post under same username. We do know he has hsv1 and 2. 2 is not definite in the sense of possible false positives as previously discussed. I have hsv1 already and not clear if that positive test is indicated of oral or genital though I can think back to times where
I had pain on my lips and may be able to attribute that to hsv1 oral. Now I am becoming increasingly concerned the flu like symptoms of headaches, short sharp body pains, fatigue, chills, mild sore throat for the last handful of days could be ars. My partner was tested negative March 25 for hiv and claims his last intercourse before me was prior to 4 weeks of us having initial sex (March 19). I don't know what test his clinic in NYC did. I just know now I want to get another hiv test. When is the soonest I can have this done - 4 weeks from the condom breaking March 19) or 4 weeks from the last Time I performed oral sex (March 25)? Thanks. 
53 months ago
Sorry - yes she swabbed for viral culture which she says takes 1-2 weeks 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
53 months ago
Yes, I saw his previous results, but forgot that you had HSV 1 already.  So if you have HSV 1 already, it is extremely unlikely that you would acquire HSV 1 genitally by receiving oral sex so in this particular case, the location of your HSV 1 is not really important to know.   so it looks like the swab test that was done is culture, as you stated, not PCR which is the best swab test  - far more sensitive than culture.  But really - let's think this through.  As I recall, you had a broken condom exposure (plus some protected exposures) with someone who has a very questionable HSV 2 result.  Really, I think your risk is quite low here and you may be overthinking this a just a bit.  I'm not being at all critical of your concerns - just trying to help you put a little perspective on this. 
I seriously doubt that you need to worry about HIV but you can certainly test again if it would give you reassurance.  Results of the 4th generation test at 6 weeks are very very accurate.  There is also a combined P24 and antibody test available now that looks for new infection that you may wish to investigate.

Best
Terri
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