[Question #7802] Fidelity

 
16 days ago
I have just tested positive for genital herpes via a swab test.
I had an IgG of 2 (reference up to a maximum of 2).

I am in this relationship with the girl for 17 months. She doesn't remember any outbreak in her life, but has had other symptoms like discharge, burning, spotting - thought they were just yeast infection, etc. She has multiple sexual partners and had unprotected sex but say she has been faithful. I have had sex no one outside of the relationship.

We have been having sex about 4 times a week for the past 16 months with no condom (from when she started the pill).

Questions -
1. Does my low value of IgG confirm that this is a new infection?

2.  She has never had a herpes test before, but has taken the same antibody test. Her results would be out in a few days. Would her test value shed some light on the truth?
a) If her IgG is not highly positive then does it mean she's had the virus for a while and so could have been before the relationship ? But is the high value, in this case, less likely because she has not had an outbreak?
b) If she's negative for antibody or weakly positive, it means she's just gotten it recently?

3. Given that she has not had an outbreak - does it imply that she has a new infection only?

4. Is it possible that we have been together for 2 years but I am just getting herpes now? Or has she probably cheated in the recent past?
Would she be able to transmit but not get blisters herself?
I read that twice a week sex without protection a couple has typically a 4% chance of female to male transmission per year. Given our sexual history of unprotected sex of 4 times a week for a year and a half what can you make of the chances of non-transmission?

5. a)I also had a urine PCR test and the results come today. Will this also help?
b) Do I need to repeat my antibody test - can it be wrong?

I would like to know this for the sake of our relationship. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 days ago
There is something wrong with how you are reporting the index value of your IgG test, unless you don't live in the US and are doing a test other than the usual tests.  Are you saying that you tested positive for HSV 2 with a value of 2?  I'm confused.  If you have an index value of 2, then it could be a new infection, yes, or an old one.  How soon after sores showed up did you do the test?
1. Does my low value of IgG confirm that this is a new infection?
It could be, or an old one. 
2.  She has never had a herpes test before, but has taken the same antibody test. Her results would be out in a few days. Would her test value shed some light on the truth?
a) If her IgG is not highly positive then does it mean she's had the virus for a while and so could have been before the relationship ? But is the high value, in this case, less likely because she has not had an outbreak?
that is exactly what it could mean.  80% of people who have HSV 2 don't know it and often, sadly, find out they are infected by infecting someone else.

b) If she's negative for antibody or weakly positive, it means she's just gotten it recently?
A negative would be useful but a low positive could mean a false positive also
3. Given that she has not had an outbreak - does it imply that she has a new infection only?
no
4. Is it possible that we have been together for 2 years but I am just getting herpes now? Or has she probably cheated in the recent past?  It is certainly possible that you've been together all this time and you didn't get it.  The other option is that she has had another partner somewhere along the way.  it's just not at all certain that she did.

Would she be able to transmit but not get blisters herself?
Yes
I read that twice a week sex without protection a couple has typically a 4% chance of female to male transmission per year. Given our sexual history of unprotected sex of 4 times a week for a year and a half what can you make of the chances of non-transmission?
More sex, more risk, so maybe an 8% chance per year?  And it is not cumulative.  So the odds are definitely on the side of her being infected a while ago.

5. a)I also had a urine PCR test and the results come today. Will this also help?
Absolutely not.  Why was that done?
b) Do I need to repeat my antibody test - can it be wrong?
I thought you were diagnosed by swab test.  If that is true, then you don't need an antibody test as well.

Terri

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