[Question #7722] HSV 2 testing, transmission

23 days ago
Hi Terri, thanks so much for this resource. I have tested low positive IgG for HSV 2: On 10/14/20 it was 0.94, 11/30/20 - 1.29, on 12/31/20 - 1.51. I know this could be false positive. If results increase like this though is it more likely positive? I will retest in May and consider a western blot from there. Meanwhile, the person who gave it to me tested positive, so it seems likely I am positive. So far I have been asymptomatic except for some tingles. 
Then, I just want to be clear on what I can do without risking transmission with a new partner. I know it's rare to pass HSV 2 from kissing, but if it's possible, do I have to disclose before kissing? (I am HSV 1 negative) Can I pass HSV 2 giving unprotected oral sex - I am female giving to male. If it's rare do I have to disclose first? Can I pass it receiveing unprotected oral sex?  If he touches my genitals does he need to wash his hands before touching his genitals? I know we can't touch genital skin together, but what about thighs, bellies, buttocks?  Assuming no blisters are present. I just want to know what I can do before having "the talk." Lastly,  what are the side effects of repressive treatment and how common are they? I am very sensitive to meds and am leary of taking it. 
Thank you again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 days ago
No, tiny increases like this do not make it more likely that this is a true positive.  With your numbers, there is an 85% chance that this is a false positive result.  I personally see no reason to continue spending money on IgG tests.  If your value was going to go up significantly, it would have done it by now.  If your exposure was in October of 2020, we are 6 months out now.  I would not assume just because your partner was positive that you are.  I think you should do the blot now for a clear answer.

I do not think you need to disclose this before kissing,  no, or before giving unprotected oral sex.  IF you are infected, and that's a big IF, it is very unlikely that you would pass this to the mouth of someone giving you oral sex. I don't think washing hands is necessary.  You can touch thighs, bellies, and buttocks without worry.  And I don't think you should tell someone you are positive at this point but you could say you have unclear testing results.  But get the blot now and you'll know if you ever have to have the talk. 

Most people have no more side effects on the antiviral medicines than they would, taking a placebo.

Terri


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21 days ago
That is all very hopeful and helpful, thank you! Yes, I would have been exposed in late September/October,  and took my 3rd IgG on 12/31 with that slight increase. If I did another IgG in May (going in for my annual anyway) might there be the chance of a larger increase then that would be more definitive? Or, does the minimal increase 2 months after exposure seem to show that it's going to stay in that low range - in other words, at 2 months it would have increased if it was going to.  If you are saying it's most likely to stay in the low range then yes, I will pursue a blot ASAP, and yes I see how to on your site. It's pricey though so I am just trying to take the best strategy as I decide.
The other detail is that I had this one other partner and then I reunited with my ex boyfriend with whom we had been monogamous. I got tested for everything early in our relationship and it was all negative. He said he had all negative results too from previous testing and not having had a partner since. With all this going on he got tested for HSV (after telling me he found out he had never been tested for Herpes afterall - I know that patients aren't screened for it unless they ask, which is what happened in his case). His IgG for HSV 2 came back low positive - 0.9 or so. So I also had assumed I infected him and he's in the early stages. Meaning, if he already had HSV 2 it would have been much higher IgG right? I know he needs further testing too... but it was another reason I just assumed I in fact do have HSV 2, and most likely gave it to him, and not him giving it to me. What are your thoughts? 
Lastly, in terms of sexual contact, sounds like as long as I avoid genital to genital touching and penetration without protection, everything else is a go. Is that right? 
Thank you so much - as I was navigating all of this your online information helped me so much with staying in a good place in my head. Truly a godsend.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 days ago
If you do another Igg and the value is greater than 3.5, then we would be concerned.
And the blot is pricey, no question, but for many people, peace of mind and clarity are very important. 
0.9 is negative, not positive, so I'm a little confused about your partner's result or interpretation of results.
You are correct about the kinds of contact that are OK until you get the blot results, yes.
I'm glad we could be helpful for you.

Terri
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20 days ago
I guess I should have said my partned tested equivocal, which can possibly mean positive. He will do further testing whenever he has a new partner. We just figured it was what it was since we were in a relationship. 
To restate my question, would my IgG results show a relatively final value at 2-3 months past exposure? Or, do you think a test at 6 months could possibly show an increased value that might be more definitive? Again, I am just weighing whether to get another IgG or to go ahead and jump in with the blot. 
I know this is my last follow up - so thank you again. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 days ago
Equivocal is not positive. 
The IgG test is as good as it is going to get at 12 weeks out.  Whatever shows up at 6 months would not be more useful than 12 weeks.  I wouldn't bother with another IgG if I were you.  Just jump to the blot and bite the bullet financially, if you can, to get the best answer possible.


Terri
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