genital herpes

[sally653]

Hi I am hoping to get some clarification about testing for herpes.  I was in a relationship in which I had unprotected sex with someone and I do not know their herpes status.  I do no have any symptoms at this time.  I asked my healthcare provider for a type-specific test, but was advised not to get one as I do not have symptoms and because I know for a fact that I would test positive for at least one type since I frequently get cold sores.  Essentially, I was being told that there is no way to know which type I have orally, so without genital sympoms, a test would be inconclusive.  I have been doing some research, and I feel that it is safe to say that if I test positive for type 2, I have genital herpes.  I would really like to take the type-specific test for some peace of mind.

Would you agree with this?  Please advise.

[Terri Warren, RN, Adult Nurse Practitioner]

The vast majority (and I meant well over 95%) of people who have HSV 2 have it genitally, and even if they have no symptoms, shed virus from the genital area.  The CDC STD treatment guidelines that you can find at the CDC website CDC.gov, also states that the person who tests positive for HSV 2 should consider themselves genitally infected.  I really don't agree with your clinician advice.  The question is, if you are infected with HSV 2 would you not want to know for the slight possibility that it might be oral vs. the overwhelming suggestion that it is genital and you might infect someone else without knowing?  This is obviously completely your choice - lots to think about, I'm sure.

Terri

[sally653]

Terri, thanks for your response.  I think the reason that I'm being told not to get this test is because I have not had any symptoms of infection in the genital area, so testing positive even for type 2 cannot tell me for certain that I have a genital infection, as it is possible to be exposed orally as well.  I have spoken extensively with two different clinicians who have reviewed my medical history and they have both come to the same conclusion.  If it is not completely true that I will necessarily spread this genitally, then why would I want to live with that guilt and responsibility? I am just trying to get my facts straight... thanks for your help.

[Terri Warren, RN, Adult Nurse Practitioner]

I would definitely agree with you, no question.  If you have cold sores, then you would test positive for HSV 1.  If you also test positive for HSV 2, you should consider yourself infected with herpes genitally.  You request and desire is completely normal and admirable.  If your provider will not do the test, they don't understand herpes testing, and that's unfortunate.  However, you can order our own type specific HSV 2 antibody test (IgG) on the internet at a variety of website, including one called Healthcheck.  So check it out.  Do not order IgM and you don't need HSV 1.  Best of luck with this, you are on the right track.  Don't be dissuaded.  

Terri