Hi,

July I had my first genital outbreak. Last sex contact with others was before my wife of 9yrs. We don't believe she has HSV, never had an outbreak & she has Lupus & shes had full panel tests before. I got full panel blood & swab test in Sept. Tested again in Dec.  

TEST1

hsv1 IGG - 53.50

hsv 1/2 IGM - HSV1 NEGATIVE, HSV2 NEGATIVE

hsv culture - specimen quality: adequate, hsv culture: not isolated(Does this mean the culture was not affirmative?!)

TEST2

hsv 1/2, IGG - 22.40, IGM - 1.44

HSV1 glycoprotein G, IGG - 52.10, HSV2 - 0.20

varicella-zoster AB, IGG - >4000, IGM - 0.69

1)With these positive tests, is the Western Blot warranted at this point? Its just so odd that if I was infected prior to being monogamous with my wife that my first outbreak is now 9yrs later & never got infected by me(assuming shes not). She tried to get tested UrgentCare refused cause no outbreak. The TEST2 also tested for Shingles as I did have chickenpox as a kid and wondered if it was the rare gential shingles.

2)if these 2 tests confirm positivity, what are the chances of me passing it to my wife. Seems like Lupus exasperates Hsv. We will never have sex while an outbreak is occurring but the main issue is thru asymp. shedding. We will use condoms as protection from now on & wouldn't be against my idea of a plastic barrier for the general groan area for extra protection. She really needs some confirmation that she will be safe as do I.

Thank You Experts!

Your HSV 2 antibody test was negative for HSV 2 and your swab test was negative as well.

You mention that you had your first outbreak genitally - may I ask how you know that this was herpes for sure?

Do you have a history of ever having cold sores in your lifetime?

I hope you can clarify these issues for me. 

thanks for posting!

Terri

Thanks for clarifying the swap test was negative.  Odd though since it was probably at the height of the outbreak.  

I'm still curious about what made you so clear that this was a herpes outbreak - was it the appearance?  What did it look like?  Did a clinician tell you it looked like herpes? 

You do have a high HSV 1 antibody response - perhaps this outbreak, if that's what it was, is genital HSV 1?  Hard to know because your swab test was negative. 

To note, the first test didn't look for HSV 2 specifically, or if it did, it's not written down here.  But the second one did look for HSV 2 specifically and it was negative.  As was the culture.  Since it was negative, I'm wondering if this was actually herpes at all?

Terri

The clinician at the UrgentCare thought it was Hsv when she saw it and swabbed it.  She swabbed it pretty hard and it hurt but who knows if it was enough.  

I had the tingling sensation symptoms for few days before the outbreak.  Painful red fluid-filled looking blister/vestibules clusters, mainly on lower part of penile shaft and testes but a few elsewhere on penis, few on buttocks and few on right inner thigh.  Then after taking Valacyclovir prescribed by clinician, I noticed an immediate affect on the outbreak.  They started to crust over and eventually fall off after about 2 wks.

I'm only saying its HSV because of the high hsv1 IGG readings on both tests as well as what the clinician saw.  And yes it was in the genital area if I didn't make that clear.  So i'm assuming genital hsv1.  

Do you think I should still do another confirmation test using the Western Blot method even with the two tests and high IGG readings?

I'm not clear that a western blot would add much information at this point.

We know this is not a brand new infection unless your wife is infected and recently infected you.  If she has been tested, you would know, but just because she has Lupus doesn't mean she has been tested for herpes.  If she does test for HSV and is negative for HSV 2, we can take that off the table.  It could be HSV 1 but it could be something else entirely since the culture was negative and it was aggressively swab tested.  You are positive for HSV 1 but it doesn't necessarily mean that THIS is HSV 1.   Herpes lesions are not red fluid-filled, BTW, and recurrences are rarely scattered around like those that you describe.  I'm sorry I can't help you know exactly what that was.

Terri