STDs Expert Forum
Chance of getting HSV-2
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Chance of getting HSV-2

Hello,
I recently got tested for STD for the first time, and it came back that I was HSV-2 positive (through a IgG test).  I have had 1 long term partner my whole life, and once in high school I preformed oral sex (unprotected) once on another boyfriend. Recently when my long-term partner and I broke up for a few months, I had sex (unprotected) with a male (he also gave me oral sex unprotected) in mid February and again with him at the end of March.  Before both times of having sex, he was tested for STDs and was negative for everything (including HSV-2). I realize the IgG test is not accurate until 4 months after contraction of HSV-2, and with the test results from that man, I’m certain it was not from him.  I confronted my long-term partner and asked him if he ever cheated on me. He told me that back in high school (about 11 years ago now), he had unprotected sex with a girl for “a few seconds” and then changed his mind and pulled out.  Can you contract HSV-2 that easily?
My long-term partner states that he has never had any symptoms, and I haven’t had the typical symptoms either (sores, etc)—though I have had a number of yeast infections from this past Aug-February.  I had been having pain during sex, but thought it was due to the yeast infection or my hormone levels from being on the pill and subsequently being very dry.
I do have HSV-1 (I get cold sores right before I come down with a cold), but have had that for as long as I can remember.  They did not test me for HSV-1, but will next month when I go back to the doctors.
My questions are:
1. Can you contract HSV-2 as easily as 1 time for a “few seconds”? Could I have contracted it from my one time of performing oral sex in high school?
2. What is the chance of the other man (who I slept with in Feb and March) contracting it? He has had no symptoms thus far.
I’m sorry if these questions sound silly, I’ve never dealt with anything like this and am confused about the situation.  I appreciate your insight.
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239123_tn?1267651214
Welcome to the STD forum.  I'll try to help.

I agree that your sexual history makes HSV-2 quite unlikely.  The HSV-2 blood tests are not perfect, and false positive results are fairly common, especailly if the test was not strongly positive.  Before speculating about when and how you caught it, let's first judge whether the test is accurate.  Check back with your doctor's office and try to learn a) the specific test that was done, by trade name; or if it was done by one of the national labs, which one (Labcorp or Quest); and b) the numerical value of your HSV-2 result, which will probably be a figure between 1.1 and 5.0.  With that information, we can at least start to judge the validity of the result.

In view of your history, my guess is that your result is not strongly positive.  If so, you likely do not have HSV-2 at all.  If it's in a gray zone, when you provide the numerical result, we can discuss confirmatory tests that will sort it out.  In the meantime, herpes diagnosis and the HSV-2 blood tests are among the most common topics on this forum; you can find several discussions by just scanning the threads of the past couple of weeks; or use the search button and enter "HSV-2 blood test".  Here is one recent thread to get you started:

http://www.medhelp.org/posts/STDs/Low-positive-for-HSV-2---some-questions/show/951529

Best regards--  HHH, MD
13 Comments
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Avatar_f_tn
Thank you for your response.  Here the answers the the questions you asked me to look into: a) lab:Specialty laboratories in Valencia, CA (it was a Herpes Simplex Virus Type 2 IGG ABS Serodx (Herpeselect) Test) and the b) the value: 1.40 (which according the the reference range, greater than 1.10 is positive; 0.90-1.10 is equivocal and under 0.90 is neg.)
Does this test and its value sound accurate that I am positive for HSV-2?
Thanks for your help.
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239123_tn?1267651214
Thank you for the additional information.

Probably you do not have HSV-2.  Although a value of 1.40 is technically positive, most truly positive results have values of 3.5 and higher.  There's probably less than a 50% chance you have HSV-2.

You can do one of two things.  First, have another HSV-2 test with a different commercial test, such as the BiokitUSA HSV-2 test.  Alternatively, go directly to the HSV Western blot test, the ultimate gold standard for HSV antibody testing.  It is done only at the University of Washington clinical laboratory in Seattle; your local laboratory will know how to refer a specimen for WB testing.

Most likely the BiokitUSA or Western blot test will be negative.  If so, it will prove you do not have HSV-2, regardless of the original test result.

Please return to the forum one more time with the result of one of these confirmatory tests.  But while you wait for the result, you can assume you probably do not have HSV-2.
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Avatar_f_tn
Hi Dr.,
My long term partner's test came back and it was negative (he had HerpeSelect done and his value was <0.90).  Between my long term partner's test results being negative and the partner I had sex with in February and March showing me negative results prior to us having sexual contact, do you think my HerpeSelect is a false-postive? I am having an immunoglobin test done soon and possibly also a Western Blot. I will post those results when I have them.

Also, I have had HSV-1 for as long as I can remember (cold sores on my inner lip right before I get a cold--not too often, 1 a year maybe). I was wondering a few questions about that: 1. What is the chance that I gave HSV-1 to my sex partner (in Feb and March) either in his mouth? 2. His genital area?  I did not have a cold sore at the time, but understand that I could have been shedding and not known it.  We had unprotected oral sex multiple times.
Thanks for your insight.
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239123_tn?1267651214
Given those addtional results, you can be reasonably sure you do not have HSV-2.  I expect your Western blot to be negative.

Half of all adults in the US have positive blood tests for HSV-1, and those people are immune (or at least highly resistant) to catching it again.  So there is a 50% chance your partner could not have caught your HSV-1 even if you tried to transmit it.  Also, HSV-1 usually is transmitted during actual cold sores.  Although asymptomatic viral shedding occurs, it appears to be less important in transmission than for genital HSV-2 infection.  If your partner did not develop oral or genital symptoms of herpes, most likely you did not infect him.
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Avatar_f_tn
Hi Dr.,
thank you for your response. One more quick question, my doctor wants to run an immunoglobin test--is this an accurate test to run? She told me that I do not need to be active (symptomatic) to have a positive result to this test.  

thank you for responding about the HSV-1, my sex partner is very concerned about his health and I would hate to have given him anything accidently. he has not had any oral or genital symptoms yet, so hopefully he did not acquire HSV-1 or HSV-2.
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239123_tn?1267651214
"Immunoglobulin" test is meaningless; every HSV antibody test measures immunoglobulin (antibody) against HSV.  Just make sure she plans to have a type-specific HSV test by a reputable laboratory.

If your partner remains nervous, he could have his own blood test for either or both viruses.
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Avatar_f_tn
Thank you. So I need to get a Western Blot done then it sounds like. Thanks for clarifiying that, I dont want to have a test done that shows nothing significant.
My partner is getting tested--but waiting for the 4 month mark of our last sexual contact to have accurate results.
I appreciate your help. I will post again when I have the results from my next test.
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239123_tn?1267651214
Well, it still might make sense to start with another standard antibody (immunoglobulin) test before you spend $150+ for WB, which might not be covered by your health insurance.  If a repeat standard antibody test is definitely negative (ELISA ratio 0.9 or lower), you can stop there.
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Avatar_f_tn
Ok, thank you. I forgot to mention, my dr. ran a PCR test (negative) but then she found out that it would only show true results if I was active (and at the time of the test I had no symptoms). I'm a little concerned with my dr.'s knowledge about HSV testing, but they are the fastest way to get a test done (a referral is a month and a half wait). Is there a specific immunoglobin/std antibody test you recommend? I've had the HerpeSelect done and now this PCR test. Sorry to keep posting questions.
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239123_tn?1267651214
Since you have had HerpeSelect, have a different test this time.  If your doctor can send the specimen to LabCorp, one of the two large national laboratories, they will do the Trinity Biotech test, trade name Captia.  

You are correct about PCR; it is not intended for use except when there is an overt herpes lesion.  A positive PCR proves herpes with great reliability, but a negative test is meaningless, especially in the absence of lesions.
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Avatar_f_tn
Dear Dr. HHH,
I had the Western Blot test done a few weeks back and just got the results from my Dr's office.  They spoke with the WB office in Seattle and verbally Seattle was able to tell my doctor that I was negative for both HSV 1 and 2.  Thank you very much for your help with this matter!
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239123_tn?1267651214
That's what I expected.  Congratulations!  Stay safe.
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