[Question #8990] The transmission rate of HSV-2

37 months ago

Hello there. I have had a recent sexual partner I am dating and we had unprotected sex one time. Unfortunately, he gave me chlamydia, which, he didn’t even know he had because he had no symptoms. We had sex 4 weeks ago, one time, unprotected. I had a full clean std panel prior to dating him and was in the clear. My question is now, what is the likelihood I have HSV-2? Genital herpes has been overall a fear of mine my entire dating life, and I do have HSV-1 so I’m prone to cold sores. I get tested today for HSV-2, but I am freaking out that I could have this now as well. I do not have any lesions or active sores, I checked myself often and nothing ever seemed suspect. Just want to know probability and transmission rate in case he was asymptomatic shedding at all? All I’ve been doing is crying and worrying.

Thank you in advance.

Terri Warren, RN, Nurse Practitioner

37 months ago

I'm sorry you got chlamydia. The good news is that chlamydia is far easier to transmit at a single unprotected sexual encounter than HSV 2 is. If you have no active sores or lesions and the encounter was four weeks ago, I think infection is unlikely. Would he agree to be tested, do you think? If he is negative, then I think infection in your is particularly unlikely. For you to be infected, he would need to be infected with HSV 2 and be asymptomatically shedding virus at the exact moment that you had unprotected sex. that seems very unlikely to me, how about you?

Terri

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37 months ago

Hi Terri! Thank you! No lesions that I’ve seen and I checked multiple times a day.

He is going to to get tested, he had no idea he had chlamydia as he had no symptoms and feels terrible. I want to throw a monkey wrench in here though, we had sex 7/16, I got a lip tattoo procedure on 7/25 and took oral acyclovir (imported from Colombia) from 7/23-7/26 to prevent a cold sore since I’m prone to them and lip procedures can cause them. I assume doing this would impact my ability to get any blisters or lesions, is that correct? Since acyclovir is used for HSV. Should I retest for HSV-2? My blood results took place 4 weeks post unprotected sex exposure. If he is positive for HSV-2, what are my chances of being positive as well, now knowing the above?

Terri Warren, RN, Nurse Practitioner

37 months ago

Great additional question. A short course of antivirals such as the one you took will not impact any testing that you do. We worry about a course of treatment that lasts longer than a couple of weeks.

The likelihood of transmission of HSV 2 is related to the frequency of unprotected intercourse. Did you get your test results back yet?

Terri

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37 months ago

Hi Terri. Yes I did, it is negative:

HSV-1 IgG Antibody Positive HSV-2 IgG Antibody Negative
These results indicate prior exposure to Herpes Simplex Virus Type 1.

Should I retest at all in the future? I’ve read the most accurate reading is at 6 weeks.

Also. What if my partner is positive? Would I need to retest then in that case?

Terri Warren, RN, Nurse Practitioner

37 months ago

At 6 weeks out from a concerning encounter, 70% of those who are going to be positive will test positive on the IgG test.

Given that you've had no lesions, given you test negative so far, given that it was a one time encounter, I seriously doubt that you have HSV 2. If you want to retest at 12 weeks if you are still worried, you could, but the odds are that it will be negative as well

If your partner tests positive, then you will surely want to test again at 12 weeks out

Terri

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