[Question #6921] Genital Herpes

9 months ago

My girlfriend said that when she had her initial outbreak she was prescribed by an urgent care doctor the recommended dose (1g of Valtrex twice a day for 10 days, good for two refills). Is it possible that she actually wasn’t having her first outbreak that day and just wanted to get prescribed to prepare for when her first outbreak will occur because her blood test results (antibodies) were positive? Or are physicians not allowed to prescribe that dose (and for that many refills) unless there is, in fact, an active outbreak/infection happening?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
Clinicians can prescribe antiviral medicine for herpes in any way that they feel is appropriate.  She was given a prescription for a first episode infection but if she already had antibody at the same visit where this was prescribed, then she was more likely having a recurrence than a first outbreak.  And if she wasn't having any symptoms at the time of the visit, then I'm just not sure what this prescription was about.  Can you clarify?  What is your concern, specifically, please?

Terri
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9 months ago

I’m just trying to retrace whether I got it from her or a previous partner.

 

I got tested (blood antibody test) on day 1 of my initial outbreak and the results came out positive a few days later, 5 days after I think I got it. Is 5 days too soon for antibodies to form in the body? What is the soonest for herpes simplex antibodies show up in a blood test?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
what was the index value associated with your positive result?

Terri
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9 months ago
Igg type-specific: HSV1 - 1.03, HSV2 - <0.91
Igm:  HSV1 - 2.04 (ratio), HSV2 - n/a

These are my index values from a test I got 3 months later. I don't have those on hand from when I originally got tested 5 days after but I remember my test results saying I was higher in antibodies for HSV2. I'm pretty sure that these results at least mean I have HSV1, but I'd like to hear your thoughts.

We don't have my girlfriend's original index values (from 7 days after contraction) but we could definitely look them up (she never got retested later). If I'm not mistaken Igg ones can't pop up until much later, meaning our initial tests must have had only Igm antibodies?


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
9 months ago
well, I don't know about any earlier results, but these say you don't have HSV 2.  And your HSV 1 index value is so low you may not really have that either. 
The IgM test is terrible - lots of false positives - and the CDC says never to use it.  It would be good if someone reviewed her antibody results as well.  So if she had a positive swab test from an outbreak, it would be best to know which type was recovered.  If she ONLY had an antibody test, that should be reviewed.

Terri
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