[Question #830] Do you think I contracted hsv-2?

51 months ago
Hello,

I recently started dating someone who said she was std checked when her IUD was inserted. Nineteen days ago (may19th) when we had sex I noticed a small cold sore in her mouth and asked her about it. Long story short she's had "fever blisters" since childhood. She said she took a valtrex two days prior to our having sex. The cold sore was healing and smaller. 

I went and took hsv-1 & hsv-2 tests 13 days afterwards. I have no genital blisters or cold sores, only predromal symptoms in my lips the last four days, no blisters.  Could this be nerves and anxiety? Today is day 18. The test was the  ELISA SEROLOGY. My test came back negative for hsv-1, but inconclusive for hsv-2 with a reading of .9.  I am scheduled to take another test in 6 weeks. 

What are your thoughts and advice? Am I orally contagious as well? 

Thanks. 




Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
If you are risk for anything specifically, from your description, it would be HSV 1, the cause of recurrent fever blisters.  HSV 2 orally is quite uncommon indeed. 
Frankly, you tested too early.  What you basically have here is a baseline result - what you were before you had sex with her.  Yes, your HSV 2 is in the equivocal range and it COULD mean that you are in the process of serconversion (going from negative to positive) but that is less likely.  If you are going to test again, to allow more time to make antibody if you are going to, I would retest in 6 weeks from the encounter, which it sounds like you are already planning to do.  In a way, it is good that you have a baseline test - it gives you something to compare to.  So I am assuming you had intercourse as well?  Protected or not?

Terri
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51 months ago
Thank you for your answer. We had unprotected intercourse as well. Trust someone saying they've been checked and here I am. Never again. 

For the record we also had unprotected sex on April 30th. No cold sores were visible during this. That's 5 1/2 weeks ago. 

I have had two raised streaks inside my lower lip as of the last week. The doctor I saw said they weren't herpes as he was looking for blisters. These are raised and red on the inside of my bottom lip to the outside lip line. They are not visible on the outside of my mouth with my lips closed. 

Do you have an idea what the streaks are and should I order a Western Blot test now? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I'm sorry, I don't know what the streaks are but herpes does not present as streaks. 
It is also possible that you do have HSV 1 already and the antibody test missed it - it misses about 30% of HSV 1 infections, compared to western blot. 
I don't think it is necessary to order the western blot now.  Wait a while, hopefully 12 weeks from last exposure,  and redo the IgG. The IgG becomes positive earlier than the western blot so in that sense, it is a better screening test, particularly for HSV 2.

Terri
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51 months ago
Thanks Terri! I had a second test done this Monday. Almost three weeks since intercourse. The first test through Labcorp came up negative for hsv-1 and .91 for hsv-2.  
My most recent test through Quest came up negative for both hsv-1 & hsv-2. The score was under .90. 
Per your website I've almost passed the 50% mark. Three weeks is this Thursday.  I plan on taking another test at six weeks from contact.  The wait is killing me!
 How does antibody build up occur in the body? Could she have an outbreak of HSV-1 and not have outbreaks of HSV-2? Lastly, she took Valtrex two days before our intercourse. How could this have affected transmission of the virus? 
Thank you for all of your help!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
Her taking antiviral therapy certainly reduces your risk.  Antibody is built when your body sees the herpes antigen and responds by making antibody - it's a little bit like a lock and key.  She could certainly have had an outbreak of HSV  1 and not have active HSV 2, definitely.  I know the waiting is really hard but there is no replacement for that unless you develop an active lesion, in which case you should get it swab tested right away, but I'm betting you won't.

Terri
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