Unsure and looking for some answers

In January 2010, I was diagnosed with HSV 2. I had never had any symptoms or outbreaks and still haven't. I was negative for HSV 1 and positive for HSV 2 with a score of 2.75. I met with another doctor a few months back and she said that I should have never been tested in the first place because I don't have symptoms and the herpes blood tests aren't always right and that the test should complement a cultured lesion. She mentioned that since I haven't had an outbreak, it's possible that my body developed immunity to the virus and won't ever have an outbreak. She also said that it's possible that cross-reactivity could have played a role with the positive results and that I may in fact, not have the virus. She said that I could still be shedding the virus if I do have it and not know it and that there isn't any way to be sure. After speaking with a couple of family members, I decided to get tested again last week. I was called yesterday and the the results were positive for HSV 2 with a score of 4.66. Should I just accept the fact that I have herpes or should I pursue further testing (i.e. WB from U of W)? The test that I had done was the Herpeselect for HSV I/II. Is it possible that the test is picking up something else or is this wishful thinking on my part? Does a high antibody level mean that my body produced a lot of antibodies because the virus was "awake" and more antibodies were produced to kill the virus?

Even though I don't have outbreaks, I know it's possible that I'm shedding virus. Is it possible for me to pass the virus even if  I use condoms and I don't have an outbreak? How likely is it that a virus infects cells, lays dormant, and doesn't produce antibodies for years and then will "wake up," initiating an immune response? I'm asking because is it possible that I had the virus before I tested positive? I had neg herpes tests before that but could I still have been infected and not developed antibodies because the virus was dormant for so long?

[Terri Warren, RN, Adult Nurse Practitioner]

If the test was a combined HSV 1/2 as you seem to imply, then it means nothing.  However, you say above that that it was type specific for HSV 2, so I am a little confused.  Were there separate tests for HSV 1 and 2?  

If you are truly positive for HSV 2 at 4.66, then there is little chance that this is a false positive.  If you want the western blot to confirm, that can be done, certainly.  Some people who test positive that have had no symptoms still want the western blot to provide clarity.  The value really means nothing as long as it is truly positive.  This level is quite normal, not high, not low.  

Yes, it is possible (and likely) that you are shedding virus when you have no symptoms.  If your test is a true positive, then you are both infected and infectious to others.  It is definitely possible that you were infected before you had the test done, but if you tested negative previously, then you were infected somewhere between the negative and positive tests.  Are you actually sure that you were tested for herpes before?  Often STD testing does not include herpes testing.  

Antibody develops between a couple of weeks and four months after infection.

Terri

[rachh2]

Hi Terri,

Thank you for your response. The test that I just had performed was the HSV 1/2 (IgG), Type-Specific Abs (HerpeSelect(R)). I don't know much about this test but it should differentiate between the antibodies, right? Also, what would cause the difference in antibody levels from the previous test that I had done a couple of years ago? Is the test that I just had done specific enough where it wouldn't be worth getting a follow-up test?

I can't honestly be sure about the previous testing. When I'd get checked and have my annual women's exam, I would tell my doctor that I wanted to be checked for all STDs. Doesn't that imply that I want to be checked for herpes as well? Could you please tell me why some health professionals do not always include a test for herpes? The gyn that I mentioned in my first post said that there's controversy in the community about whether or not people should get tested when they don't have symptoms. Why is that? Why wouldn't all doctors/NPs include a herpes test as part of the STD check?

Lastly, I've been dating someone for ~2 months and we haven't had sex nor have we had "the talk." How can I protect him if/when we do have sex and how likely is it that without symptoms, I can still transmit the virus to him if we use condoms?

Thank you again.