[Question #9078] HSV2 two different test results

36 months ago

I’ve been with my partner since we were teenagers. About 3 years ago, we broke up and during that time, I had unprotected sex with someone else. The next day, my body felt off so I went to my OBGYN who informed me that I had a yeast infection (I shaved the night before and lathered cream around that area which didn’t mix well with sweaty sex). The diagnosis made sense but something didn’t feel right with me, so I opted to take an std blood test. They told me that I was positive for HSV2 and HSV1, (which I’ve had since I was a child and never experienced a cold sore). I took another IgG HSV2 test 2 months later which was again positive at 1.38. A few months later I got back together with my bf and told him everything. He is fully supportive and as we were getting back together, we took another full panel std test for each other- this time that third IgG test came up as negative for HSV2 at <.90!

Almost three years have passed and I’m still extremely confused about my results. I’ve never had an outbreak, have no idea what HSV2 looks like, but I’m still terrified of passing it to my partner through shedding. I’ve spent these years full of heartbreak and apprehension. I want the freedom of being able to have sex and be close to each other whenever we want but I’m so worried about his health. I’ve had the thought of getting tested again but don’t know if I could mentally handle whatever the result will be. I guess my first question is: could the first tests have been a false positive, maybe due to me already having HSV1 and if not, why would I have had a negative test?

Terri Warren, RN, Nurse Practitioner

36 months ago

Oh my goodness! There are many false positives in the low positive range (1.1 to 3.0). Yours is likely that, but if you want additional confirmation of your negative status, you could do the best antibody test, the herpes western blot and get this cleared up once and for all. You can work with the University of Washington and your own provider to get this test or I can work with you to get it at westoverheights.com.

There can be some cross reactivity between HSV 1 and HSV 2 on the IgG test, yes.

Terri

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36 months ago

Thank you, Terri! I asked a PA this when I first got that negative result and they said it could be that the virus is now dormant and the antibodies aren't showing up in the test, so whether or not I have it has been messing with my head ever since. I will try the western blot test that you suggested. If it does come out to be positive and I've been asymptomatic this entire time, could you tell me the risk of a female passing it to a male through unprotected sex? (we use condoms right now but I don't see that being a practice for the rest of our lives if we stay together as a monogamous couple). I've read that it's almost like a 5% chance a year but there's a lot of misinformation out there. Also, how exactly does it pass from skin to skin? For example, if I have an ingrown hair or something and there's an open wound and we have sex, could the virus spread from that wound and transmit it to him? I get them around my pubic area often and obsessively check myself every time before sex because again, I have no idea how this works!

Thanks so much for your help!

Terri Warren, RN, Nurse Practitioner

36 months ago

Female to male transmission, in couples that have been together for a while, having sex about twice a week, no condoms, no daily antiviral medicine is about 4% per year. That is about 4 men out of 100 in that situation would be HSV 2. Add condoms, the risk is reduced by about 65%. Add daily antiviral medication, reduced by about 50%.

Virus can be shed from think skin, like the labia or vagina, with no obvious break in the skin. Checking yourself for lesions is fine, but shedding can happen with totally normal looking skin.

Terri

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