2nd Opinion

[2ndopinion]

Four years ago (May, 2002) I was diagnosed with HSV-2.  At the time of diagnosis I didn’t have any real symptoms other than what looked like a very small sore. The doc didn’t even think I needed to be tested but I a requested it anyway. As it turned out the result was positive. Since then I have not had any symptoms, or at least none noticeable to me.  I know that one can go for years without symptoms but this seemed a little odd to me so I recently returned to my lab report.  I was tested with the ELISA IGG assay for type 1 and type 2 and Quest Diagnostics was the laboratory used.  My EIA value of type 1 was 0.13 and value for type 2 was >5.00.  According to the lab printout, I was negative for type 1 (since it was < .90) and was positive for type 2 (since it was > 1.10). I had accepted the doc’s diagnosis but since I never received a second opinion on this I would love your opinion on a couple of issues:

1) How reliable is this test and is it pretty certain that I have type 2 given such a high EIA value? The doc at the time said it was very reliable and that he was pretty sure I had it based on the results.

2) Would you recommend I get tested again to confirm given my 4 years of no symptoms? Or should I just chalk it up as having type 2 and being lucky that I have had no noticeable breakouts?

3) If I do have it, and by chance I was to transmit herpes to a partner, would their symptoms most likely be as mild?  

Thank you very much for your help with this.

[H. Hunter Handsfield, M.D.]

I'll go straight to your questions.  You also have had an accurate and useful response from gracefromhpp, below.

1 and 2) That test result is 100% reliable.  You definitely are infected with HSV-2 and there is no point in repeat testing.

2) The odds you will transmit may be small or large; it is impossible to predict for any particular person.  See my reply to biggestfool in the thread immediately before yours.  Over time, the frequency of both symptomatic recurrences and subclinical shedding decline, but probably never to zero.  But if you do transmit to a partner, there is essentially no relationship between the severity of that person's symptoms and your lack of symptomatic outbreaks.  Most people would agree you have an ethical obligation to discuss the possibility of HSV transmission with any and all sex partners.

Perhaps not what you were hoping to hear--but there it is.  Best wishes--  HHH, MD

[gracefromHHP]

Your test was well above the numerical results that indicate a confirmatory test is needed.  You have hsv2 and are negative for hsv1 as you already know. No reason to retest with your results.

Even though you aren't noticing obvious symptoms of ob's you are still actively shedding the virus as much as someone who gets the average number of ob's - 4 to 6 a year does.  Keep that in mind if you are in a discordant relationship and your partner doesn't have hsv2. Oh and be glad you aren't having frequent ob's!!!  Trade you anyday!!

There is no way to predict how herpes would present in a partner should they contract it - it's different for everyone.

If you haven't already be sure to check out the herpes handbook at www.westoverheights.com - it's a terrific resource to learn about herpes, treatments and how to reduce transmission to a partner. It's also quite useful to give to a potential partner so that they too can learn more about herpes.

grace

[2ndopinion]

Thank you for your response. Actually your response is what I had expected. As I mentioned, I had assumed the doctor was correct and my current partner is aware of me having HSV. I just thought it was a good idea to get a second opinion since although this doctor was accurate in diagnosing, some of his actions were inappropriate which have led me to be less than confident in him. As an example he left a message on my answering machine at my home telling me I was positive for HSV-2! He didnt know if I lived with someone or not, and even if he knew it was private, that seemed pretty cold to me. I was also just wondering about the worst case scenario with my girlfriend and what to expect.  Sounds like its impossible to predict (but she is fully aware that it is possible to contract it).

Thanks again.