Genital Herpes

[meli522]

My daughter was recently diagnosed with genital herpes.....she is only 18..she just started
college and she met an upperclassman and she has been with him a few times....her breakout happened approx 3 weeks after one of their encounters.........she had flu like symptoms, developed a fever,swollen glands and then the lesions appeared........she went back and told the young man who went to the school infirmary to be tested....his blood test came back negative....my daughter is devastated....she does not know how that could be........what is the percentage of false negatives with the blood test and could this young man actually be positive.......

[gracefromHHP]

Does your daughter know if she has hsv1 or hsv2 genitally? It's important for her to find out which type she has. It will help her in decisions as to how to treat her herpes from here on out and also it will help her and future partners figure out what precautions, if any, are needed in the relationship.  

I encourage you to forward the link to the herpes handbook at www.westoverheights.com to your daughter. There is also a terrific patient counseling video there for her to watch.  Also encourage her to reach out for support if she hasn't already.  There's an under 25 forum at the herpeshomepage.com website that she might be interested in.

No matter which type she has - it's not the end of the world by no means!  Thankfully herpes is for the part a nuisance and if she ends up having frequent symptoms they can be well controlled with medication.  1 out of 4 women in the US have hsv2 genitally - it's a lot more common than most folks think it is.  Kudos to you for being there supporting her so she can talk about what she's going thru with someone who cares about her :)

grace

[H. Hunter Handsfield, M.D.]

Most likely you are confusing the HSV window with that for HIV.  About 50% of people with new HSV-2 infection will have positive HerpeSelect results by 3 weeks and 60-70% at 6 weeks, but it takes 3-4 months to get up toward 100%.  It takes even longer for other commercial tests (e.g., Kalon, in wide use in the UK) and longest of all with Western blot, which takes 6 months to reach 90%.

[boy2]

"It takes up to 3-4 months to develop a positive blood test"

I've been reading this forum for months and thought that 6 weeks was the accepted window to develop antibody. I had a HSV test done at 5.5 weeks after possible exposure and it was negative. Are you saying this could've been too soon?

Thanks,

[H. Hunter Handsfield, M.D.]

My condolences; this obviously is difficult for you, and having gone through my own daughter's teen and college years, I can imagine your pain.  Still, you might be overreacting.  Genital herpes isn't fun, but it isn't the end of the world. Properly managed, most people eventually find it to be nothing more than a minor inconvenience.  In the long run, your daughter is not likely to have any serious health consequences from it.

Three weeks is a long delay for new genital herpes symptoms; more often the onset of symptoms is 3-7 days.  So I have to wonder how accurate her sexual history is or whether the diagnosis is correct.  Assuming her diagnosis is accurate, the main explanation for a negative blood test result in her partner is that he too had an early infection--that is, he might have acquired his infection only a few weeks earlier.  It takes up to 3-4 months to develop a positive blood test.

I cannot say much more on the basis of such indirect information. I don't mean to imply you aren't being truthful.  But we're dealing with what your daughter told you, what her partner told her, and you then passing the information on to someone who cannot examine or talk directly to anybody.  The best I can suggest is that she continue under the care of her provider, take the treatment as prescribed, and if in doubt about the diagnosis, seek another opinion.

Best wishes-- HHH, MD