[Question #7342] The difference

4 months ago
I’ve been diagnosed recently with HSV2 on my genital after having an outbreak a couple days after having  unprotected oral sex and then protected sex.  I was diagnosed two years ago with HSV1, which i was aware of because of two separate occasions I’ve got  cold sores on my lips due to sun exposure. Since my outbreak, I had a tingling feeling on my upper lips after my hsv2 outbreak but no cold sore surfaced, however, my lips were swollen for a couple days. I treated it with tea tree oil and taking supplements.  It’s been 3 weeks after my genital outbreak and still slightly recovering it. My doctor prescribed me 500g valtrex yesterday and I will be taking it daily. Today, I’m noticing tingling feeling on my lower lips.  What are the chances that I have transfer hsv2 on my lips as well even though i already have hsv1 orally? How am i going to tell the difference which is which  if a cold sore were to surface ? I’ve been anxious and depressed with my diagnosis and I’m so afraid i probably have hsv1 & 2 orally. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
to answer your question best, can you tell me exactly how you were diagnosed with HSV 2?  Swab test from a lesion that was typed?  Blood antibody test?

Terri
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4 months ago
It was from a blood antibodies. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
And was the test an IgG or IgM test and if IgG, what was the number associated with the positive result, please.

Terri
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4 months ago
It was a IGg test 

Hsv1: 52.40 
Hsv2: 1.21
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
So that index value of 1.21 has an 85% chance of being a false positive result, based on our prior research that has been published, comparing IgG low positive index values (1.1 to 3.5) with gold standard western blot results.  So just to be clearer, for people who obtained an index value of 1.1 to 1.5 and who also did a western blot, 85% of those positive IgG results were NOT positive by the best test, western blot.  Now to be super clear, if you had the antibody test done very soon after newly contracting HSV 2, the number could be low for that reason as well.  Since I don't know all the timing here, I cannot say for sure what's going on.  What should have been done is a swab test of the outbreak.  You may wish to re-do the IgG test about 6-8 weeks out from the first test and see if the value has gone up significantly.  If not, then I would recommend the western blot for clarification.  I know your concern is transferring HSV 2 to your mouth, if you have it, but I think the chances of that are remote.

Terri
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