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Combined HSV 1/2 Test
I had a herpes test recently. The name of the test was HSV 1/2 combined Ab SCREEN, IgG. The chart I was given says that with this specific test, a 0.89 or less indicates no infection. My test was 0.88. I also had a combined IgM test done, which was a 0.76, indicating a negative as well. I understand that test is pretty pointless but I figured it was worth noting. I've seen it mentioned that the combined IgG test isn't accurate in determining the difference between the two in the event that one is positive, but is it safe to say this (my) result is accurate in determining whether there's an infection at all? Thank you for any and all info.
I did mention that, "HSV is most contagious with an active lesion and the second most contagious time is during prodromal symptoms, ie 24 hours before the lesions appearance"
From the same scientific journal written by doctors who have researched herpes significantly. "At least 70% of the population shed HSV-1 asymptomatically at least once a month, and many individuals appear to shed HSV-1 more than 6 times per month. Shedding of HSV-1 is present at many intraoral sites, for brief periods, at copy numbers sufficient to be transmitted"
The above was taken from this scientific journal: (http://www.ncbi.nlm.nih.gov/m/pubmed/17703961/)
I understand your math, however, for 100 sexual episodes a year, that same individual could be shedding coincidentally on 20% of those 100 episode, the issue is you don't know when you are shedding so it's impossible to tell and even if your not as contagious, it's still possible to transmit.
I like to error on the side of caution, thats why the best thing to do is get tested at 16 weeks with an IGG or Western Blot to rule it out, because the only way to confirm whether or not the individual has hsv is to get tested at 16 weeks when the IGG test is most accurate.
From the same scientific journal written by doctors who have researched herpes significantly. "At least 70% of the population shed HSV-1 asymptomatically at least once a month, and many individuals appear to shed HSV-1 more than 6 times per month. Shedding of HSV-1 is present at many intraoral sites, for brief periods, at copy numbers sufficient to be transmitted"
The above was taken from this scientific journal: (http://www.ncbi.nlm.nih.gov/m/pubmed/17703961/)
I understand your math, however, for 100 sexual episodes a year, that same individual could be shedding coincidentally on 20% of those 100 episode, the issue is you don't know when you are shedding so it's impossible to tell and even if your not as contagious, it's still possible to transmit.
I like to error on the side of caution, thats why the best thing to do is get tested at 16 weeks with an IGG or Western Blot to rule it out, because the only way to confirm whether or not the individual has hsv is to get tested at 16 weeks when the IGG test is most accurate.
That is not correct. Shedding of the virus does not equal infectiousness. Most shedding instances might trigger a PCR detection but there is insufficient amount of the virus for practical infection.
For example, the female to male annual transmission probability when avoiding outbreaks (but not asymptomatic shedding, including a proportion just before an outbreak) is 5% per annum.
This is usually assumed to be across 100 sexual episodes in the year. Hence each sexual episode is about 5%/100 or 0.05% or 1 in 2,000. If however shedding only occurs 20% of the time, then there are 20 sexual episode that involve shedding, hence the chance is 5%/20 or 1 in 400.
The male to female transmission rates are about double female to male.
For example, the female to male annual transmission probability when avoiding outbreaks (but not asymptomatic shedding, including a proportion just before an outbreak) is 5% per annum.
This is usually assumed to be across 100 sexual episodes in the year. Hence each sexual episode is about 5%/100 or 0.05% or 1 in 2,000. If however shedding only occurs 20% of the time, then there are 20 sexual episode that involve shedding, hence the chance is 5%/20 or 1 in 400.
The male to female transmission rates are about double female to male.
If a true herpetic blister was present the day after you may have had unnoticeable symptoms the day before. HSV is most contagious with an active lesion and the second most contagious time is during prodromal symptoms, ie 24 hours before and after the lesions appearance.
On top of that, asymptomatic shedding happens anywhere from 3% - 20% of the year regardless of symptoms. So the chances of spreading are more most likely more than 1 in 200. (http://www.ncbi.nlm.nih.gov/m/pubmed/17703961/)
The best thing to do is get tested 16 weeks post exposure to see if you have it or not, the IGG is incredibly accurate at 16 weeks, or you can also get a western blot test which is more accurate. It's best to know what you have but you need to wait for the antibodies to develop for accurate testing.
On top of that, asymptomatic shedding happens anywhere from 3% - 20% of the year regardless of symptoms. So the chances of spreading are more most likely more than 1 in 200. (http://www.ncbi.nlm.nih.gov/m/pubmed/17703961/)
The best thing to do is get tested 16 weeks post exposure to see if you have it or not, the IGG is incredibly accurate at 16 weeks, or you can also get a western blot test which is more accurate. It's best to know what you have but you need to wait for the antibodies to develop for accurate testing.
Hi Grace,
I was wondering if you could perhaps weigh in on this entire thing. Fleetwood20 has been very insightful and I was wondering if you found his logic/statistics to be sound. Also, do you feel as though his comment on me kissing her a day before what appeared to be the beginning of a cold sore leaves me with a 1 in 200 chance of getting it. Thank you kindly.
I was wondering if you could perhaps weigh in on this entire thing. Fleetwood20 has been very insightful and I was wondering if you found his logic/statistics to be sound. Also, do you feel as though his comment on me kissing her a day before what appeared to be the beginning of a cold sore leaves me with a 1 in 200 chance of getting it. Thank you kindly.
Infection rates with HSV are not skyrocketing, in fact they are reducing. Never before has such a lower percentage of the population had HSV1/2.
I have gathered my knowledge from reading the various medical papers over the years. I do not have immediate recall of specific papers that accord with my observations, some of which are based on my own calculations.
For example. On average about 50% of people get HSV1 before adulthood and another 25% thereafter. Let's assume that the 25% get their infection from the partner, but some won't, might be Aunt Fanny.
This means 50% of couples are in a relationship where one had HSV1 the other doesn't. (25% where both do and 25% where both don't).
Hence partner transfer is about 25%/50% which is half of couples. Not bad in a lifetime of sex and intimacy!
There are papers that confirm at least 75% of people experiencing a primary infection experience outbreaks and it is probably greater. The half statement refers to the period beyond six months of infection.
I have gathered my knowledge from reading the various medical papers over the years. I do not have immediate recall of specific papers that accord with my observations, some of which are based on my own calculations.
For example. On average about 50% of people get HSV1 before adulthood and another 25% thereafter. Let's assume that the 25% get their infection from the partner, but some won't, might be Aunt Fanny.
This means 50% of couples are in a relationship where one had HSV1 the other doesn't. (25% where both do and 25% where both don't).
Hence partner transfer is about 25%/50% which is half of couples. Not bad in a lifetime of sex and intimacy!
There are papers that confirm at least 75% of people experiencing a primary infection experience outbreaks and it is probably greater. The half statement refers to the period beyond six months of infection.
Also, if you are able to source the "well over half of couples who are in this position never transfer their HSV1 infection in a lifetime together," I would be eternally greatful. Many thanks to you sir.
Well putting aside the state of her immune system, the justification of my paranoia, and the moral argument of whether it's neglectful to disclose your HSV1 status, I truly appreciate you taking the time to respond. I have a few specific questions regarding your response if you'd please take the time to answer them.
1) I've seen figures showing that with/without condoms/antiviral therapy, the chances of passing HSV to a partner hangs around 1-4% in a year. I believe that's probably referring to genital HSV infections specifically, but nonetheless, contraction rates are skyrocketing, and HSV-1, which is generally associated with oral infection, is now becoming extremely prevalent in the genital region [I feel as though it would be safe to assume that's due to rapidly changing sexual practices (i.e. more oral sex) as compared to years ago]. Given these things, I find it hard to believe getting HSV-1 from kissing someone is as difficult as you make it seem, and most likely occurs the vast majority of the time asymptomatically. Also, could you point me to a source that states "Some virus is usually present in the hours before a lesion commences to appear. Your chances would not exceed 1 in 200."
2) It would seem that somewhere in the range of 75-90% of people who contract genital herpes are asymptomatic period. I've seen different figures regarding oral HSV-1 but it appears around half or more never show symptoms, but you claim "a primary HSV infection does not generally appear unannounced." I was wondering if you had anything to elaborate or add on regarding this. Sources and figures are very much appreciated.
You are a kind, benevolent soul Mr. Fleetwood. I cannot thank you enough for taking your time to give personalized response and participate in this discussion, and I think I speak for everyone on this forum when I say that. It has made me feel immensely better regardless of the outcome of my results. I must ask though, what are your specific credentials? Are you a health care professional?
1) I've seen figures showing that with/without condoms/antiviral therapy, the chances of passing HSV to a partner hangs around 1-4% in a year. I believe that's probably referring to genital HSV infections specifically, but nonetheless, contraction rates are skyrocketing, and HSV-1, which is generally associated with oral infection, is now becoming extremely prevalent in the genital region [I feel as though it would be safe to assume that's due to rapidly changing sexual practices (i.e. more oral sex) as compared to years ago]. Given these things, I find it hard to believe getting HSV-1 from kissing someone is as difficult as you make it seem, and most likely occurs the vast majority of the time asymptomatically. Also, could you point me to a source that states "Some virus is usually present in the hours before a lesion commences to appear. Your chances would not exceed 1 in 200."
2) It would seem that somewhere in the range of 75-90% of people who contract genital herpes are asymptomatic period. I've seen different figures regarding oral HSV-1 but it appears around half or more never show symptoms, but you claim "a primary HSV infection does not generally appear unannounced." I was wondering if you had anything to elaborate or add on regarding this. Sources and figures are very much appreciated.
You are a kind, benevolent soul Mr. Fleetwood. I cannot thank you enough for taking your time to give personalized response and participate in this discussion, and I think I speak for everyone on this forum when I say that. It has made me feel immensely better regardless of the outcome of my results. I must ask though, what are your specific credentials? Are you a health care professional?
I am not convinced that it is neglectful to not disclose HSV1. This an exceptionally common virus that most partners will have. There is nothing more that a person can do but avoid contact when an outbreak is present or suspected, or more than is expected.
Note that well over half of couples who are in this position never transfer their HSV1 infection in a lifetime together. This is because the chance of infection outside of an outbreak is exceptionally low. There is simply not enough virus present to infect someone.
You mention a bump appearing a day after kissing her. Some virus is usually present in the hours before a lesion commences to appear. Your chances would not exceed 1 in 200.
You are letting paranoia over an insignificant virus impact you and your perspective of your partner. You know nothing about her immune system.
The most telling of all is that you have had no symptoms. A primary HSV infection does not generally appear unannounced.
You are negative, I have little doubt. The issue though is that your next partner will probably have HSV1, what will you do then?
Note that well over half of couples who are in this position never transfer their HSV1 infection in a lifetime together. This is because the chance of infection outside of an outbreak is exceptionally low. There is simply not enough virus present to infect someone.
You mention a bump appearing a day after kissing her. Some virus is usually present in the hours before a lesion commences to appear. Your chances would not exceed 1 in 200.
You are letting paranoia over an insignificant virus impact you and your perspective of your partner. You know nothing about her immune system.
The most telling of all is that you have had no symptoms. A primary HSV infection does not generally appear unannounced.
You are negative, I have little doubt. The issue though is that your next partner will probably have HSV1, what will you do then?
She had an atrocious immune system and was constantly sick too. I can't believe she didn't load me up with the virus all those times, which were well over 3 months ago at this point.
Well I got the test 4 weeks prior to the last exposure with the person who was positive. She was positive for HSV 1 and neglected to tell me until a month before we stopped dating. We were together from August 2014 until the very end of January 2015 so about 5 or 6 months. She never had an outbreak the whole time I was with her, but I kissed her on a Friday night, and Saturday afternoon she had a red bump on her lip. She took something that she claimed stopped them before they formed and it never developed into anything, but in the same vein I guess we'll never know if it was a possible lesion or not. She also claims her prodrome symptoms and the formation of the bump typically come a few hours before the beginning of an outbreak. Anyhow, at the 4 week mark I got tested and those were my results. I plan on getting tested at the 2 and 3 month marks as well, I'll make sure I do specific tests for those. I honestly can't believe it didn't come up as positive yet though.
A negative is a negative, very much so for a combined test that is quite sensitive. Are you sure the result isn't <0.89 or similar?
The IgG test is far from pointless in the negative, it just doesn't give you any information if positive, as it is for over 60% of the population. The combined IgM is triggered by a reasonable proportion of people upon infection, but not all, and is sometimes not present for very long. Hence it is of quite limited diagnostic value. Nevertheless a negative is a good sign such that with no genital symptoms you can conclude with confidence that you do not have genital herpes up until 12 weeks prior to the test.
This does beg the question as to why you tested and what window period did you allow?
The IgG test is far from pointless in the negative, it just doesn't give you any information if positive, as it is for over 60% of the population. The combined IgM is triggered by a reasonable proportion of people upon infection, but not all, and is sometimes not present for very long. Hence it is of quite limited diagnostic value. Nevertheless a negative is a good sign such that with no genital symptoms you can conclude with confidence that you do not have genital herpes up until 12 weeks prior to the test.
This does beg the question as to why you tested and what window period did you allow?
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
