[Question #765] understanding Herpes

52 months ago
I am a 58 yo divorced woman (after 20+ yrs of marriage) without any STDs.  I have had one partner post divorce who stated he was neg for STDs.  We have lived together for 1 1/2 years with unprotected sex.  I had an outbreak of blisters and tested positive for HSV-2 with an IGg blood test 5 mos after the outbreak.  I waited to be tested so it would be more accurate. I have had only the initial outbreak and two small blisters on my lips that went away with acyclovir. He has not gone for testing and believes he is neg.  He does get oral lesions.  Could this be HSV-1 since i have only one outbreak and 2 blisters on my mouth even though the it came back pos for 2? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
When you mention that you had an outbreak of blisters, was that oral or genital?  I know you said you've had oral blisters, but have you had genital ones as well? Were the blisters swab tested and were positive for HSV 2 or do you have only the blood IgG test?  Can you tell me then number associated with the positive result (it is called the index value)? Thanks

Terri
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52 months ago
I first outbreak was genital. The HSV 2 lGG type specific AB value was 3.03.  I did not get a swab in the beginning because of the conflicting info and not being able to get in time before they started to heal.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
And Maria, have you had recurrences of these blisters? It looks like no from your description but I want to be certain I am understanding you correctly.   I now you've had them orally - have you had any genitally?  And did you get your oral lesions around the same time you got the genital ones the first time?  Your index value of 3.03 technically falls into the low positive range - 1.1 to 3.5 and we know that about half the people who test positive in that range are false positives, not real positives.  However, the closer you get to 3.5, the more likely the results will confirm by the gold standard western blot.  So, for example, at 3.03, there is probably a 90% chance that this positive result will confirm with western blot antibody test.  The western blot is also quite a bit more effective at picking up HSV 1 infections than the screening IgG test.  Without a positive swab test from a genital lesion and without recurrences, if you were our patient, we would confirm your status with a western blot antibody test, just to be certain.  We would also recommend getting a swab of a genital lesion or oral lesion if you get any more, too. 

Terri
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52 months ago
I have NOT had any more genital blisters since the first outbreak in Sept.  I have had the two small oral blisters after the first and that's all, no more genital blisters. I never got "fever blisters" before these.  I believe my partner is going to get tested and will have to see what his results are.  I suspect if he is positive for HSV -2 then it is highly likely it is positive for me? I am trying to work through this issue not just with the diagnosis but the sense of betrayal.  Not sure if the relationship will survive but will need to know moving forward.  In that vein, I will look into the Western Blot test just to be certain.  Do you need to specify that you are testing for HSV 1 or 2 or will it just pick it up if you test for Herpes?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
Our website can provide you with ability to get the western blot through a study we are doing with the University of Washington.  westoverheights.com. 
Given no recurrences, I think it would be good to confirm, Maria.  If it is any comfort, 80% of those infected don't know that they are infected, so it could be completely unintentional if he transmitted to you.

Best
Terri
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52 months ago
Thank you Terri.
In gratitude,
Marla
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
You are most welcome, and sorry for seeing that "l" as an "i"! 

Terri
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