Follow up from previous thread/recent results

Hi Terri,

I accidently originally posted this on the herpes community, and I wasn't able to post further on my original thread, so I apologize if it makes more work for you to have to check our previous interactions. Here is the link to my original thread:

http://www.medhelp.org/posts/Herpes/Symptoms-questions-regarding-HSV2/show/1789796

After an extremely long ordeal with a lot of mental and physical pain, I have my recent test results. These are 15.2 weeks post exposure (my calculating was a tad off, but I'm sure it's close enough to 16 weeks). Everything (HIV, hep, Sphyillis) was negative...including HSV2!! I was so thrilled it brought me to tears!! My Dr told me that I almost certainly would have tested positive right now, and she didn't recommend further testing.

My HSV1 number was still positive (it was 2.5 at 5 weeks) and at 15.2 weeks it was up to 3.0. My dr said fluctuation in the value is normal, and nothing to really stress about. I don't get actual cold sores, just a bump on my lip from time to time that's never been swabbed because it never opens up or blisters. My exposure in July didn't involve oral at all, just vaginal sex, so should I have any concerns over a hsv1 genital infection? If it was a newer infection and I was still converting, would I have expected a larger rise in the index value than just .5?

I am still having an extremely watery discharge with slight vaginal discomfort daily, but my dr never finds yeast or bacteria (they've tested me twice for chlymidia and gonorrea)! I remember you saying that herpes wouldn't cause this discharge on a daily basis, so that is comforting to known that wouldn't be a cause.

Would you recommend a western blot to test my hsv1 since it is below the 3.5 range?

I greatly appreciate your final thoughts about my recent results, and also if you agree with my drs comments as well. You have been so unbelievably valuable and reassuring, and I am beyond thankful! Thank you Terri!

[Terri Warren, RN, Adult Nurse Practitioner]

Well, you could do a western blot to be very clear about the HSV 1 status if you wanted to, i"m guessing it might confirm what you got on the ELISA.


I agree that you can relax about the HSV 2 once and for all now.  Great news for you, I know you were so worried!

Terri

[Beyondfrightened]

Thank you so much Terri!! I appreciate your input! :)

So, do you think it really isn't worth going through with a western blot??

Do you think it's accurate to say that I shouldn't really be worried about hsv1 genitally since there was no oral from my exposure? If my partner hypothetically had a hsv1 genital infection, is that not efficiently spread through vaginal sex?

I appreciate your time so much!! It's so great to be able to get advice and input from an expert!

[Terri Warren, RN, Adult Nurse Practitioner]

If you want to be clear about your HSV 1 status, a western blot would help.  Neither the western blot nor the ELISA are quite as good at picking up HSV 1 as they are at picking up HSV 2, but if it was positive for HSV 1, the answer would be clear.  HSV 1 is not as easily passed from the genital as the mouth.

Terri

[Beyondfrightened]

Thanks Terri!!

If I were your patient, what would your advice be? I'm inclined to just pass on the western blot and just move on from all of this, but I'm curious as to what you would advise!

Do you have any concerns at all that I may have acquired hsv1 genitally from my exposure (again, no oral at all...just very brief unprotected sex).

Thanks again for your time and wisdom! It's appreciated more than you know!!

[Terri Warren, RN, Adult Nurse Practitioner]

All our low positives (1.1 to 3.5) get confirmed.

Terri

[Beyondfrightened]

Thanks Terri!

If I do decide to confirm, is it easiest to just go through you to obtain a WB? I would need to call your clinic to become a patient...is that correct?

It's so nice to have tested negative for hsv2 4 months post exposure...I just wish I had a better idea about my hsv1. Since I've never had a full blown cold sore, I just feel slightly concerned that I may have acquired it genitally through sex. I know hsv1 is not shed often from the genital track as often as hsv2 is.

Thanks again Terri!! :)

[Terri Warren, RN, Adult Nurse Practitioner]

You can test through our clinic or you can order the test kit directly from the University of Washington.

Terri

[Beyondfrightened]

Thanks once again Terri!

I am still contemplating on the confirmation western blot. I am still having a lot of health problems (daily lower back problems, watery discharge, occasional urinary issues), so I may just focus on getting that figured out first. I've been reading about prudendal neuralgia...interesting stuff as I have a majority of those symptoms!

Terri, coud you be so kind as to provide your expert opinion regarding the possibility of acquiring a hsv1 genital infection from vaginal sex? I've finally got hsv2 concerns out of my head as I tested negative, but I'm just a smidge worried about a genital infection. From what I've read, it really isnt transmitted efficiently through sex.

If you could be so kind as to provide some insight for me, I would greatly appreciate it!

Thank you, and have a wonderful day!!

[Terri Warren, RN, Adult Nurse Practitioner]

You can acquire HSV 1 from intercourse, yes.  Its harder to get than HSV 2, but it can happen.

Terri

[Beyondfrightened]

Thanks Terri!

I can totally understand that HSV1 genitally can be transmitted via sex. Since it is possible, do you by chance have any odds/ statistics to say or show how often this happens?? Have you seen many cases of a hsv1 genital infection being acquired this way??

Where should I go from here? In your opinion should I be concerned that I potentially aquired HSV 1 genitally due to my low positive? A WB could confirm If I do or don't have it, but it wouldn't reassure me as to where. I've had two swabs in the past 4 months of suspicious areas in my vagina, both of which have come up negative for types 1/2.

Again, my exposure was a brief (very brief) single unprotected intercourse.

As always, thank you for your time. If you would be so kind to comment on these last issues I'm having, I would be content with getting out of your hair!! :)

[Terri Warren, RN, Adult Nurse Practitioner]

We don't have statistics about HSV 1 genital to genital transmission, no
You are correct - a positive antibody test won't tell you where your HSV 1 infection is, only whether you actually have it or not.  

Terri

[Beyondfrightened]

Thank you Terri once again. If you would be kind enough to answer a few final questions, then I think I would be content to take your advice and professional opinions and move on.

1) Since there are not actual statistics about genital hsv1 genital to genital transmission, I am curious as to how many times in your professional career have you seen this? Espcially from a single brief exposure.

2) How should I feel about my low positive HSV1 test results? Since I have never had a full blown cold sore that I can remember, I just cant say for 100% certainty that it is an oral infection. I've read from both Dr. Hook and Dr Hansfield say that almost half of the US population have HSV1, and a majority of those are asymptomatic infections.

3) I could do a WB,but like you said, it probably would just maybe confirm HSV1 positive. Since my HSV2 was completely negative at 15 weeks, do you recommend any further testing? Am I in need of any other ELISA's to maybe see what my HSV1 number does?

4) Is the difference in my HSV1 5 week Elisa (2.5) and my 15 week Elisa (3.0) significant? I understand both values are in the low positive range, but I am just not sure if a .5 varience in the numerical values are significant or not. If my HSV1 was a brand new infection either genitally or orally, would I have maybe seen a higher increase between the testing windows than just .5?

Thank you Terri. I am so grateful for your time and expertise. You have helped me through a very trying and confusing time, and I appreciate it greatly.

[Beyondfrightened]

Hi Terri,

I was wondering if I could bump this thread to see if maybe you had some insight/responses to my last 4 questions? I fully intend to let this thread close, but I would so appreciate your advice!

Thank you!

[Terri Warren, RN, Adult Nurse Practitioner]

1) I have not yet seen this from a single sexual encounter
2)Ned and Hunter are correct.  If you want confirmation of this low positive get a western blot
3) no
4) no, it isn't

Let's stop this thread now, I have nothing else really to contribute to your situation

Terri

[Beyondfrightened]

Thank you Terri,

With all the wonderful advice I have recieved, I will let this situation go and move on with life as this entire thing has eaten away 4 and a half months.

Thank you for all of your time and patience you have given me. You provide a great service here, and Portland is lucky to have you!

Take care Terri!

[Terri Warren, RN, Adult Nurse Practitioner]

You are so welcome.

Terri