(only unprotected oral). I went to the doctor last week, and he saw no symptoms either on his checkup. I asked for a full STI checkup (HIV, Syphilis, HEP B&C, Chlamidya, and HSV 1&2) that I do every year so he requested a few exams from blood samples. Everything came back negative, except for herpes.

I had two combined HERPES 1 & 2 antibody tests, One IGG and one IGM.

The IGG came back POSITIVE with a 4.4 result ( according to the test over 1.1 is positive)

The IGM came back NEGATIVE with a 0.6 result ( according to the test over 1.1 is positive)

A year ago I did the same tests and they both came back with a 0.5 result.

Here are my questions

At this point, you are positive for HSV 2.  Condoms reduce transmission from females to males by 65% so they aren't perfect.  But neither are the herpes antibody test. I have seen many false positives at the level of 4.0 to 5.0. The CDC recommends confirmation of results below three but in my experience, that number is too low. I think anyone who has a positive IgG for HSV two without any symptoms should have a confirmatory test at this point. The best confirmatory test is the herpes western blot. It is done only at the University of Washington but you can work with your own provider or with me to get this test done but given that you have no symptoms and given that you had a negative result a year ago, I think you should do it. I don't recall ever telling anyone with a four-point for index value that they should just forget about it and move on. That's not the strategy that I would recommend at all. If you're having sex with someone at this point, I would recommend that you disclose this information  until you get a result that's different from a confirmatory test. Without any further testing at this point, you should consider yourself positive. But again, I would recommend getting the confirmatory test.

Terri

1. How do you know that I have HVS2 and not HVS1 since my tests were 1&2 combined?

Great question, and I'm sorry I missed that they were combined.  My error. You cannot know unless you get type specific testing. Are you saying the type specific testing is not available where you live?

2. I live in South America, so I don't think I would be able to get this western blot exam here. Is there a way?

Western Blotz have been sent to the University of Washington from all over the world. I personally have worked with people in China and Great Britain and Sweden and Australia. I think if you really want to do this, there is a way. But I think I would look around your country and see if there isn't type specific antibody testing done somewhere that will separate type one from type two.

3. Getting another IGG test would be a good idea to confirm? Maybe at a different lab?

Only if the different lab does type specific testing, not combined antibody testing.

4. What does the negative IGM test means? I know it is not a very reliable test but three doctors told me that the positive IGG means I had contact with the virus at some point and that a positive IGM means I could have an active infection with blisters popping up.

The three doctors are unaware of the limitations of IGN testing and the problem with false positives IgG test. Clearly, they don't know too much about herpes testing if they're basing their opinion on a combined IgG test that cannot sort out type one from type two.\

5. I've read that it is estimated that around 90% of adults have HVS1 and 15% HVS2. Is that correct?

This really depends upon the country that you live in. It's very easy to Google prevalence of HSV two or HSV one in a given country on Google. It usually pops right up and then you would know, for your country, what the statistics are. It does vary greatly from country to country. In the US for example, about half the people have HSV one about 16% have HSV two, with women being more frequently infected with HSV-2 than men.

6. By forgetting and moving on I mean that as long as I don't have active blisters and wear a condom my sex life can proceed normally. Is that correct? That there is no treatment needed if I don't have active blisters, is that correct?

Well, I think you're ahead of yourself here because we don't know what you have and we don't know where you have it but if you want to assume that you have genital HSV-2, and I think that assumption is not necessary, condoms reduce transmission of HSV-2 from men to women by 96%. Antiviral medicine, taken daily, reduces transmission by about half. So both methods used together provide a great deal of protection.

 I'm so sorry that I missed it that the test was combined- that was my error. Please feel free to ask an extra question to sort this out because of my erro

Terri