[Question #7365] Genital herpes 6 diagnosis

4 months ago
I had a vaginal outbreak and went to a nurse practitioner to get seen same day. She told me it looked like I had herpes. Took my bloodwork and a culture. Negative for hsv 1 and hsv 2. Negative for staph and strep. She had me go back for a hhv 6 blood test. Positive. She says it's most likely I contracted it from oral sex. It looks like 6 is so prevalent and exposure happens for most at childhood. My antibodies also stated this was not my first outbreak, but this was the first genital outbreak Ive ever had. It was actually very uncomfortable and not something I could have missed. Would 6 result in genital outbreaks? I cant find much literature about it.  Thank you! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
HHV 6??? Really?  something from oral sex?That doesn't makes sense at all to me.  This NP needs a herpes update, I think.  That's a childhood infection, primarily, and is not the cause of genital lesions, as far as I've ever heard.  If the swab test was a culture, it misses 75% of infections compared to the gold standard HSV PCR swab test.  You could check and see which test was done, culture or PCR.  Now that you've had a negative swab test and a negative IgG test (was the test IgG - the CDC says never use an IgM test), you will need to wait about 6 weeks and test again with IgG OR if you get another outbreak, have it swab tested again.  Has your partner been tested for HSV 1 and 2?

Terri
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4 months ago
Yes and he is negative for  other 1 and 2 as well! Anything else I should know to ask when I go back (to someone else) for a second opinion? Thank you so much for the insight. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
well, what you need is an IgG test for HSV 1 and 2, 12 weeks out from anyone else with whom you have had sex, other than this partner who tests negative.  Alternatively, I can order a western blot for you (the best antibody test for herpes) 12 weeks out.  I don't know that you need to go see someone else in person unless you have another symptom. 
Let me ask you - did you receive oral sex from this partner?  The IgG test misses 30% of HSV 1 infections (compared to the western blot) so it is possible that this partner has HSV 1 and the IgG test missed an infection in him.  Also, the IgG test misses 8% of HSV 2 (compared to the western blot).  It's complicated, isn't it?

Terri
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4 months ago
Yes, I did receive oral sex from this partner, and I have been with him for 1 year without any other partners. He has not had any other partners in the same timeline. This started a month ago now, so were about 4-5 weeks out, there was some lag time in getting results after bloodwork. I am getting all test results mailed to me, so I should have them soon to check which tests were done and compare to what you have suggested. I dont feel comfortable having sex until I do my due diligence, and I would be eager to take whatever test you consider to be the gold standard to at least get some peace of mind either way. This is such an elusive virus, and Terri you have been so great! I wish I would have run into you first!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
The best test is the herpes western blot and I can order that for you at westoverheights.com.  I think it's possible that you have HSV 1 genital infection from receiving oral sex.  The IgG test as I mentioned misses 30% of HSV 1 infections, while it only misses 8% of HSV 2 infections, so if this was herpes, I think it is more likely to be HSV 1.


Terri
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