Asymptomatic Transmission Statistics

[itschronic]

Ok, so I found out a month ago that I have HSV-1 and HSV-2. I'm male and I can't remember ever having a cold sore and I've never had noticeable genital symptoms. My doctor said that if I had regular unprotected sex with a woman when I do not have symptoms (which is all the time for me), that over the course of one year there is roughly a 2% chance that I could infect her. He said that taking the antiviral medication would only knock the percentage in half to 1% -- again, if I have no symptoms. He actually said showering before sex would be more effective than the antivirals or using a condom at lowering my chances of infecting a woman.

This seems to differ with the transmission statistics that I see on the internet, which unfortunately seem to vary widely and rarely reference a source that I can read for myself. So let me again pose my question: What is the probability that I would infect a woman if I had unprotected sex with her when I have never had any symptoms? Also, what affect would using a condom plus using an antiviral have on this probability?

Thanks in advance.

[gracefromHHP]

glad you followed up and got answers!

the herpeselect works well for most people who get it. the boards get unevenly represented by folks who might have a false positive because folks who have no reason to doubt their results ( or have good providers who are trained to confirm low positives ), typically don't seek out help with their test results.  Also the focus folks did tweak the herpeselect quite a bit a few years ago so there are less false positives than ever.  Some labs have also taken the step of automatically doing the herpes inhibition assay to confirm low positives too.  

no test is ever 100% accurate just we have no reason to doubt our routine blood work when it's normal so we never do reading into the issues with most of the testing we have done.  

[itschronic]

I drove to LA to get the Biokit/Pockit test -- I didn't feel like messing around with shipping results back and forth and waiting. The nice thing about the this test is that it's like a pregnancy test so you know your results almost immediately. I didn't have it as I had hoped.

So my advice is for anyone who has turned up positive on HerpesSelect is to get the Biokit/Poctest done as well to be sure.

Also, I would recommend that if you don't have any symptoms that you never get a HerpesSelect test. Obviously if I took it again, there's somewhat of a chance that I would again be falsely positive.

[gracefromHHP]

biokit isn't so rare for any other reason than many clinics aren't aware that it's on the market.  it's predecessor, the pockit test was very popular and then taken off the market and many clinics don't even know that there is a replacement.  No conspiracy theory going on other than a lack of better marketing.

it usually takes 2-3 weeks to get the WB back. It's your best option at this point to confirm your status.

grace

[itschronic]

I went back to my Doctor and reviewed my lab results. The results are as follows:

HSV Abs 1and2(HERPESELECT[R]), SP
HSV1 TYPE SPECIFIC Ab IgG - 5.00 H
HSV2 TYPE SPECIFIC Ab IgG - 1.40 H

So I did some research and it sounds like I'm likely a false positive for HSV-2. According to this research (http://www.biomedcentral.com/1471-2334/5/84/figure/F1) done by the University of Washington, I have around a greater than 80% chance of NOT having HSV-2. Am I reading this correctly?

Anyhow, now that I think about it, it makes sense that I have HSV-1 -- both my parents and siblings have it, I just couldn't ever remember having a cold sore. It sounds like the above research also concludes that having HSV-1 more than likely affects the results of the HerpeSelect test in that it increases the false positive results of HSV-2.

Initially my Doctor thought we should try the HerpeSelect test again, but I thought about it, and it doesn't seem like the logical step to make. The above article suggests the BioKit test, but I called the manufacturer and they don't know of a lab that can do the test in my state, Arizona. In fact, they said there are only two places in Los Angeles that do it. I'm guessing BioKit is so rare because it has a higher false negative rate than HerpeSelect?

Also, it looks like there is a Quest Diagnostics Lab in Arizona that does Western Blot, but it says that it takes seven days to get the results back.

So my overall question is what is the recommended test to take next? Also, if it does come back negative, should I take the test again to get a greater sample set?

Moreover, if it is negative, then when I get STD testing done in the future, should I bother getting the HerpeSelect test again?

Thanks again.

[gracefromHHP]

I can better help you if you can post your lab results here - ie hsv2 igg 5.5 and hsv1 igg 2.3 or whatever they are. That way we can be sure you don't need additional confirmatory testing done.

For a female partner, the risk of infection is 8-10%/year if you do nothing but avoid sex anytime you have obvious genital symptoms. Suppressive therapy cuts the risk in half. Throw in condoms too with all that and it's a 2-3% risk of infection each year.

showering before sex just makes you smell better. The virus is more than just literally laying on the skin and the heat and friction of sex works it up to the skin's surface and into your partner.  

The herpes handbook at www.westoverheights.com is a free and up to date resource that I highly recommend reading. It's also useful to recommend to a potential partner to read too.

grace