[Question #6848] HSV 2 Recurrence

12 months ago
I was diagnosed with hsv2 (via blood test, no symptoms) and just spoke to a consultant about transition prevention and we got to the topic of living with this in general. He said that when people do show symptoms, they usually have recurrent outbreaks for 2-3 years and then outbreaks become minimal or basically just go away after your body gets used to it. This relieved me IMMENSELY but anxiety kicked back in and I'm wondering if this is true? I know this infection is forever, but would I really have to deal with it FOREVER?  Is this something that will come and go sporadically or is it more of a bell-curve thing where you'll get it for a few years and then it goes away? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
Hmmm.  What was the number associated with your positive herpes antibody test result?  Any IgG test with an index value of 3.5 or lower needs confirmation by a second test.  And an IgM test should be ignored completely. 
People who truly do have HSV 2 have more outbreaks, usually, when first infected and the frequency decreases over time.  That's the usual course.  Some people stop having outbreaks altogether and some even have more over time, but most decrease over five years or so and then remain pretty stable.
Have you had any outbreaks at all?  Why did you test? 

Terri
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12 months ago
So basically I was with someone for 6 years and then we broke up for a year and are now back together. During that time of separation, I met someone and we had unprotected sex. The very next day i felt like I had an intense yeast infection. Went to the OBGYN and they swabbed me, and came back with a yeast infection and a bacterial infection. It was just something in my gut telling me I had something else so I insisted on getting tested despite the doctor’s suggestion because she said I didn’t have an outbreak and shouldn’t test. But I did anyway and my igG result was 1.38. (I got tested at 2 different labs, both positive).  I still wonder if that was actually an outbreak because I read that you could also get a yeast infection with an OB as well. I honestly am more concerned with transmitting this to my partner because I feel like we went through so much and I’d hate for him to get it and this be a constant reminder of the time we broke up and one of us got lucky and the other didn’t. And with full transparency, we can be safe now but if we end up getting married there’s no way we’re using a condom forever, so I’m really more worried about the long term and if the worst case scenario happened and he got it, would outbreaks happen constantly forever. Also, I keep reading that studies say that x% of people aged 14-49 have it and x% don’t even know, but why is the number up to 49? What happens after 50? Lol. Does it not affect people at that age or something? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
Your index value of 1.38 has an 85% chance of being a false positive.  You need a herpes western blot to determine if this is a true or false positive, but those odds are very high that it is a false positive, right?  You can work with your own provider to obtain this OR you can work with me at westoverheights.com.  It's expensive but well worth the lifetime erroneous belief that you have herpes when you don't, in my opinion.  The CDC recommends confirmatory testing for anyone with an index value between 1.1 and 3.5 because half of these results are false positives.  When was the last time you had unprotected intercourse with this other person?  We like 12 weeks after an encounter with someone whose herpes status is unknown or is known to be positive.  Do you think this other person would agree to be tested?

Terri
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12 months ago

I don’t speak to him anymore, he’s kind of an awful person haha, and when I told him about it he said he had no idea he had it (which I believe). I know it was him though because I tested negative for everything in August, had no other partners but him, and then tested positive right after. Is there any source you can provide me with about the 85% chance of a false positive? There are so many conflicting things online :(. In the time of covid I can’t physically or financially go for the western blot. Does the value of the igG test make it harder/easier to transmit? Also I know this is my last follow up question so I just wanna pretend like I totally have it and ask:

  1. Can you spread this if you have razor burn? 
  2. Anxiety lead me down the rabbit hole of googling complications and found hsv meningitis and hepatitis. What is that?! I know it’s very rare but how does that happen and does that affect people who have the vaccines for those?? 

I thank you in advance for your answers and helping me put my mind at ease. I hope you’re staying safe during this time! 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
The index value of your low positive test says nothing about the ability or lack of ability to transmit a virus you likely don't have, statistically.
IF you had herpes, razor burn has nothing to do with transmission
You have definitely gone down the rabbit hole if you are now worrying about meningitis and hepatitis from herpes.  These are worries you don't need to have.  The kind of meningitis one could get from herpes is unrelated to the one for which you would be vaccinated - the same for hepatitis. 
The difference in index values between positive at 1.38 and negative at 0.9 is incredibly small!  That's why we worry so much about false positives in this range.  If you can't do the western blot, you could re-do the IgG test and also had the confirmatory test that is optional with both Quest and LabCorp and you can order this yourself online.  I can help you with this if you want me to.  I still want you to have in your head the certain need for the blot.  I'll find the reference you requested and add it here in a separate post.

Terri
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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
. 2005; 5: 84.
Use of "biokit HSV-2 Rapid Assay" to improve the positive predictive value of Focus HerpeSelect HSV-2 ELISA
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