HSV2 test results and exposure questions

6 weeks ago on a business trip in Philippines my clients took me to a strip bar.  We got a room and what was probably a CSW each as company. She kissed me 3 or 4 times with a little tongue inside my mouth, but never for more than a couple of seconds each time.

We both remained fully clothed, although at one point she masturbated for a few seconds in front of me. She tried to touch me after she had touched herself, I pulled away but she did lightly touch my lips with her finger. I did not notice any lesions or sores on her lips or vagina.

1 week later I noticed a pale flat pink rash across my chest, the next day dizziness, fever, nausea, diarrhea and aching back,  I felt terrible similar to flu for about 10 days with fever, diarrhea and throwing up the first 2.

A week later I had a cough for 10 days and now sore larynx.

The anxiety was too much to bear so I went for a STD test.  All negative except what they say was an IGG test positive for HSV2 at value of 20.5.  I do not know what type of test.  The clinic is not exactly first rate in fact far from it.

I've never had symptoms genitally or orally but the lower back rash at the center of the spine on my tailbone that came a few times may be sacral herpes? I thought it was humidity and running in lycra shorts in tropical weather or pads my chiropractor used to apply after slipped disc treatments.

1. Should I get retested? This clinic was not great but they say it was an IGG test and a result of 20.5 Could this be false +?

2. Could HSV2 be the cause of a rash on tail bone area?

3. Back rash occurred before my encounter on the business trip, I've had no oral or genital symptoms 6 weeks after so is it reasonable to assume HSV2 isn't from kissing the bar girl?

4. Other than the kiss, I have been faithful to my wife of 10 years, could this have been dormant since college? Can i kiss my wife or make love?

5. Could I infect my wife with HSV2 genitally if I only ever get sacral herpes?

Thank you very much!

[Terri Warren, RN, Adult Nurse Practitioner]

The contact at the strip bar is of zero concern.  Put it behind you.  
I'm not able to make sense of the test score.  It might be a test called DiaSorin which has given several false positives in the past as the numbers are similar, but I honestly don't know.

If you are in the US, I think it would be good to order a confirmatory test.  I like the western blot best.  You can have the testing materials sent directly to your physician or you can order it through my clinic.  Those are the only two ways I know you can get it.  

Yes, I think it reasonable to assume if you have HSV 2 it was not from that contact.  

The back rash could be herpes, yes, if it is low enough.  Let's have you figure out how to get confirmatory testing as a first step, OK?

Terri

[LessonWellLearned]

Thank you very much for your response.  

If nothing else it's a relief to hear the kissing encounter is unlikely to be related. I live in Taiwan, not in the US, so I will need to find an alternative testing solution. My concern is whether or not HSV2 is a reportable disease here that may get me deported and lose my job and family.  I cannot find any accurate government information on this.

Is there a type of HSV blood test that is recommended in this situation?

If the cause was not the strip club, and I indeed have HSV2, I must have had this for over 10 years and have never had genital or oral symptoms or even the back rash until recently. Nor has my wife had any symptoms in 10 years of largely unprotected sex. Does this sound possible?

Lastly, until I can get confirmation from a re-test, should my wife get tested? I can't think of any good way to explain to her why I 'out of the blue' got an STD test that won't have immense repercussions, especially since it's HSV2 despite the fact that I *have* been faithful and I am 99.999% confident she has too. So I don't want to threaten our marriage by breaching the topic until I'm sure it's really HSV2.

Thanks again, your knowledge and advice is sincerely appreciated.

[Terri Warren, RN, Adult Nurse Practitioner]

You want a type specific IgG HSV 1 and 2 antibody test.  
It might be best for you to get the test first to see if your wife even needs to get tested.  did either of you have sex with anyone else before you married?

Terri

[LessonWellLearned]

Hi Terri,

Apologies for the delay in responding and thanks very much for your kind advice.

I've been able to get retested although this time I used a higher end private professional testing lab with a wide range of medical testing services and went directly to the lab to provide the blood sample. While they confirmed their HSV-1 and HSV-2 tests are type specific IgG antibody tests, once again it seems the test process and/or the results ranges used here are not the same as the US the result ranges and my results of my re-test are as follows:

HSV-I IgG 22.0(+)  RU/ml     Result: 10.4(-)
HSV-II IgG 22.0(+)  RU/ml    Result:  9.0(-)

Based on this re-test which I have a printed report of, I'm negative for both 1 and 2.  For the first test which was done through the rather sketchy clinic, I was told the results over the phone and have never seen a report, they just said was HSV-II was positive and the result was 20.5. I can't be 100% certain it's an identical test but the ranges seem similar although even 20.5 would be somewhere between - and +, so I'm unsure what to make of it. They did give the general impression on being far from competent at the first clinic.

I guess my question now is where do I go from here? I'm very relived at the negative re-test but it's still 1 against 1, at least sort of.  My plan is to do another full spectrum STD test including HSV IgG at the same private lab in 2 weeks once I get back from another business trip and hope everything is still negative.

Based on the re-test results, could you offer any insight or suggestions on what you'd advise in these circumstances?

Thanks very much once again for your advice and patience.

[LessonWellLearned]

Sorry, the test ranges didn't display correctly in the post above, I'll try again:

HSV-I IgG   22.0  (+)  RU/ml     Result: 10.4  (-)
HSV-II IgG   22.0 (+)  RU/ml    Result:  9.0  (-)

[LessonWellLearned]

Oops.. and again, sorry. Not sure why they won't display after I hit post it is correct before I do so. Maybe the symbols mess things up.

To clarify, the test ranges on the report are:

Less than 16.0 = Negative
Greater than 22.0 = Positive

[Terri Warren, RN, Adult Nurse Practitioner]

Given the ranges, it looks to me like both are negative.

Terri

[LessonWellLearned]

Hi Terri,

My apologies for resurrecting this thread but I have a new test results I'd like to get one final opinion on. I'm happy to start a new thread/question if that is more appropriate.

All are type specific IgG tests for HSV2.  The ranges given are:
Less than 16.0 = Negative
Greater than 22.0 = Positive
"Significant result" = 70.0+

Test 1: July 31   Result: 20.5
Test 2: Aug 18  Result: 9.0
Test 3: Sept 10 Result: 19.2

My questions:

1. I don't understand how I can be neither positive nor negative, could you explain briefly what this means?
2. Given none of the results are over the threshold for positive and well below the 70 which I was told would indicate a current infection, am I likely to be infected/contagious? I have never had any symptoms.
3. Given the fluctuation, but general reduction over time of the results, is it likely I am seroconverting?

Thanks very much...

[Terri Warren, RN, Adult Nurse Practitioner]

I'm unfamiliar with the test you've had and the rate of false positives and how close to the cutoffs you really are.  To me, it seems like you might be uninfected.  Where do you live?  Can you get a western blot?  I think that would be the way to really know what is going on with you.

Terri