[Question #801] HSV2 Positive - False? Future family planning?

51 months ago
Hey doc, I am out of words for the advice and education you have provided. I have stopped my risky encounters, in a monogamous relationship and have gotten over my HIV anxiety completely. Thanks a lot for that!

As I mentioned I am HSV 2 positive. I used an online testing service and got a test from quest diagnostics. On March 18th I was tested positive for HSV 2. The value was 2.8 and it was a herpesselect with type specific IGG test. I had come to terms with it but recently my relationship got serious so I got concerned with passing to my partner and the complications of a pregnancy. So I did some research.

I ran into some articles and even your responses on medhelp regarding false positives. So I started thinking of my encounters and wanted to know if I should get my hopes high or not because I ordered a western blot test kit.

I am unsure about how transmission ocurrs. It is possible skin to skin but is it normal skin to skin? 

A few facts on my past escort encounters. Any vaginal intercourse I had was protected. The condom was put on way before my penis came near the vagina. I did have a total of 3 unprotected oral, twice with the same person and in these instances there was no vaginal at all.  The condoms never broke, however I did take it off myself so my fingers did come in contact with very little vaginal fluid and I always made sure to wash my hands after that. How likely is it to get hsv2 from getting oral. As I mentioned I always used the condom, so my urethra was always covered, so how likely is transmission to occur from my testicles getting in contact with my partners pubic region and all. Like most of the people out there I do shave my pubic hair so not sure if that increase a risk or not. 

1) Given all the above details about my vaginal protected encounters and all, how accurate was my 2.8 result. I have had chicken pox when I was young and my hsv1 was negative. 

2) risk to my partner? I don't mind starting suppressive antiviral therapy even though I've mcer
51 months ago
Sorry, the post was long so I'll rewrite and you can delete that last 1. March 18th hsv2 + 2.8 quest herpesselect type specific, hsv1 -.

Past escort encounters were always protected, condom on well before intercourse. 3 unprotected oral. Did take condom off but washed hands after it. I do shave pubic hair regularly. Recently ordered a western blot test kit.

1. Can HSV 2 transmit through regular skin, like my fingers, testicles getting in touch with pubic region and all.

2. How accurate is my 2.8 hsv2 positive, do I need a confirmation or not.

3. Do people have oral HSV 2? How likely did I get it.

4. Should I start taking suppressive anti viral when me and my partner decide to get pregnant. How much risk am I putting her at?

My partner knows about my status, says she'll manage and I've never had an outbreak so she feels she can do well too.

Thanks a lot docs!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
Hi,
With a 2.8, there is about a 50-50% chance that this is a false positive result.  Overall, about 5.7% of people who take the IgG test for herpes test in the 1.1 to 3.5 range.  This range is considered the low positive range.  Within this range overall, 50% of these are false positives.  So that means about 2.8% of people will have a false positive on this test.  To clarify, I would strongly recommend that you obtain a herpes western blot to clarify this result.  You can do that directly through UW or you can do it through my clinic with a study we are doing compared IgG to western blot results.  I would not recommend doing suppression until you get clear about whether you have herpes or not, truly.  Have you had symptoms?  People don't often get HSV 2 orally, no.  At least 95% of those who test positive for HSV 2 antibody (with confirmation if needed) will test positive by genital swab test within 4 months of doing daily home genital swabbing.  When was the last time you had sex with anyone whose herpes status you do not know for certain?  If you have genital infection, then the virus is not shed from fingers and likely not testicles, though that is less certain. 

Terri
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51 months ago
Thanks for the response.  I have had no symptoms of any sort, no sores or blisters, no pain in urination either, not sure what else I should be looking for. No unusual warts either.  Everything looks normal to me. 

I don't mind doing it through your clinic, whichever is faster and convenient. I am a California resident.

How transmission occurs?  If my mucous membranes don't get in touch with any vaginal fluid or infected aysmpotmatic skin can I still get herpes? Like my testicles coming in contact with infected skin or my fingers touching infected skin? I am asking about how I can get herpes not how I can transmit. Basically did I have a true risk in the first place or not.

The last time I had protected vaginal intercourse with an unknown status was more than 2 months ago. However after that I have had protected oral sex and some light frottage with no clothes so I am not sure how much of a risk I was at. I have not had sexual intercourse since the last time I mentioned and neither have my genital rubbed on my partners vagina.  Only protected oral.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I'm a bit confused how - are you asking about the possibilities for you getting herpes if you test negative on the western blot or your past experiences?  I'm thinking your past experiences. 
Almost all genital herpes is acquired either through intercourse without a condom or a broken condom or HSV 1 by receiving oral sex from someone who has oral herpes.  What you have described above really doesn't sound like a high risk situation at all to me.  Tell me again the last time you had unprotected intercourse?  We like people to wait 16 weeks from a risky encounter before they get tested by western blot so you are not wasting your money.  If the western blot is negative and you test sooner than that, you can't be certain it is accurate.  However, if you test and it is positive, then you need not test any more.  It is positive.

Terri
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51 months ago
Yes, I was trying to assess if I really had a big risk or not. I have had about 20 partners, but as I mentioned, with all of them I used a condom. There was no gential contact without a condom except for 3 oral intercourse without a condom. I never experienced a broken condom either but as I mentioned, I did take a condom off with my own fingers. Does all of this information sound like a risk to you in the first place? Please note I tested negative for HSV1.

My last vaginal intercourse was 2.5 months ago.  I have had recent sexual interactions which were 1. All protected and if there was any penetration it was strictly oral.

Does that seem like a risk? My last unprotected ever inter course was oral only and that was in late October. I have never had any unprotected vaginal intercourse. Always protected and anything ever unprotected was   Oral only.  Your advice and help is much appreciated.
51 months ago
Also I don't mind doing a test early than 16 weeks and repeating it again if necessary.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I continue to believe that your experiences are low risk, but the western blot is the telling test.  Yes, you can do it now and repeat it if it is negative.  It isn't cheap - $250 and not covered by insurance.  www.westoverheights.com and click on "get a western blot" on the home page for instructions on how to do the video conferencing with me to get the western blot

This is your final post on this subscription - if you have more questions, feel free to renew

Terri
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