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Herpes Questions
I was recently diagnosed via blood test that I have HSV I & II. I believed I was exposed to HSV II in 2004. Over the past year, I constantly feel pain in my groin and continued burning sensation in urinary tracts. Urine test did not discover any infection. I have never had any visible symptoms.
(1) Are groin pain and continued burning sensation in urinary tracts a symptom of active HSV recurrence? They last for weeks and sometimes they get better intermittently in the day. Or could they be due to other medical conditions.
(2) I understand that symptom of HSV infections could occur much later after the initial infection. When this happens, is the symptom still is regarded as a primary infection symptom and will it be as severe as those happen immediately after infection?
(3) When my wife contracted chickenpox 12 years ago, she suffered badly. Would she likely to suffer the same if she catches the HSV viruses, since the chickenpox and HSV viruses belong to the same family.
(4) If she gets HSV II orally from me, would she be protected from getting genital herpes?
(5) If a person has mild or no symptom in the initial years, does that mean he would likely not have visible or typical herpes symptoms subsequently?
(6) Some websites say that our immune system is able to
MEDICAL PROFESSIONAL
Very interesting! Those results clearly are HerpeSelect, so you had the right test. But I have further news for you, which you might consider good - but also confusing. You may not be infected with HSV-2; the odds are about 50:50. Repeat testing can sort it out. The explanation is going to get a bit technical, so bear with me. Beware: your doctor will need educating about this. Research on this is so new it has not yet been published. But within a few weeks, a paper will appear that concerns precisely your situation. But I know what I am speaking about; I am one of the authors. Consider printing out this message and taking it to him/her.
Your HSV-1 test is definitely positive; like about half the population, you are infected with HSV-1. You probably got it as a child. Although the lab reports your HSV-2 result "low positive" range, it's actually equivocal. Don't blame the lab; the research results I am about to cite are brand new, part of them not even published yet in the scientific literature.
Among people WITHOUT HSV-1 infection (HSV-1 result less than 1.0), any HSV-2 result over 1.0 is a true positive, i.e. indicates HSV-2 infection. In people WITH HSV-1, any HSV-2 result over 3.0 is a true posiive, indicating HSV-2 infection. However, if HSV-1 is positive and HSV-2 is between 1.0 and 3.0, the HSV-2 result may or may not be real. You are smack in the middle of this category.
How to resolve it? The first step is to repeat the HerpeSelect HSV-2 test. About half the time, a repeat test will sort things out - i.e., the result will be either clearly negative (less than 1.0) or clearly positive (over 3.0). If the repeat test remains between 1.0 and 3.0, ask your doctor to have the lab send your sample to a reference laboratory that can do a Western blot HSV-2 test. The best choice is the University of Washington Virology Laboratory, where the new research was done. But there are some other labs that can do the Western blot; if your doc or lab has a preference, that's OK. (All this will cost $200 or more. But perhaps your insurance will cover it.)
Change of subject: Chlamydia blood tests mean nothing, and is not recommended for diagnosis. There is no way to know from that result whether you have (or have had) a chlamydial infection.
To answer your hypothetical question: Yes, if you have HSV-2, and if your wife contracts it from you orally, she will not then acquire genital HSV-2. But if you're thinking of repeated oral contact in the hope she will get infected and then not worry about genital infection, forget it; it won't work. Even if you have HSV-2, many years may pass before she gets infected, if ever.
Good luck-- HHH, MD
PS: When this is sorted out, you'll be a herpes testing expert, so you might as well get the terminology right. The herpes simplex viruses are properly named 1 and 2 (arabic numerals), not I and II (roman).
Your HSV-1 test is definitely positive; like about half the population, you are infected with HSV-1. You probably got it as a child. Although the lab reports your HSV-2 result "low positive" range, it's actually equivocal. Don't blame the lab; the research results I am about to cite are brand new, part of them not even published yet in the scientific literature.
Among people WITHOUT HSV-1 infection (HSV-1 result less than 1.0), any HSV-2 result over 1.0 is a true positive, i.e. indicates HSV-2 infection. In people WITH HSV-1, any HSV-2 result over 3.0 is a true posiive, indicating HSV-2 infection. However, if HSV-1 is positive and HSV-2 is between 1.0 and 3.0, the HSV-2 result may or may not be real. You are smack in the middle of this category.
How to resolve it? The first step is to repeat the HerpeSelect HSV-2 test. About half the time, a repeat test will sort things out - i.e., the result will be either clearly negative (less than 1.0) or clearly positive (over 3.0). If the repeat test remains between 1.0 and 3.0, ask your doctor to have the lab send your sample to a reference laboratory that can do a Western blot HSV-2 test. The best choice is the University of Washington Virology Laboratory, where the new research was done. But there are some other labs that can do the Western blot; if your doc or lab has a preference, that's OK. (All this will cost $200 or more. But perhaps your insurance will cover it.)
Change of subject: Chlamydia blood tests mean nothing, and is not recommended for diagnosis. There is no way to know from that result whether you have (or have had) a chlamydial infection.
To answer your hypothetical question: Yes, if you have HSV-2, and if your wife contracts it from you orally, she will not then acquire genital HSV-2. But if you're thinking of repeated oral contact in the hope she will get infected and then not worry about genital infection, forget it; it won't work. Even if you have HSV-2, many years may pass before she gets infected, if ever.
Good luck-- HHH, MD
PS: When this is sorted out, you'll be a herpes testing expert, so you might as well get the terminology right. The herpes simplex viruses are properly named 1 and 2 (arabic numerals), not I and II (roman).
Dear Soc,
I am getting more confused now. How can HerpseSelect be regarded as the most reliable test when:
(1)A retest can throw out an entirely different result half of the time ?
(2)A person obtains a reading of between 1 and 3 for his HSV 2 test, he needs to do a HSV 1 test to confirm the result. If he is HSV 1 negative, his HSV 2 test result then become conclusive, otherwise, he needs a retest or a Western Bloc test to sort things out.
I wonder whether blood test is at all meaningful.
MEDICAL PROFESSIONAL
The tests you already had are type-specific, and the most reliable tests available in standard (non-research) clinical laboratories. But if the repeat test is a Western blot, it will resolve the issue.
HHH, MD
HHH, MD
Thank you Doc.
I have already taken another test last Friday at our Government hospital, using Type Specific Test. I was told this supposed to be the most reliable test in Singapore. The result would be available in 2 to 3 weeks's time.
Best Regards
Sorry Doc, I noticed I have made some typo errors. The results of my test are:
HSV Type I IgG Antibody: 3.12 (Negative: less than 0.90
Equivocal: bet 0.91 and 1.09
Low positive: bet 1.10 and 2.87
Mild positive: bet 2.88 and 4.34
High positive: above 4.35)
HSV Type II IgG Antibody: 1.54 (Negative: less than 0.90
Equivocal: bet 0.91 and 1.09
Low positive: bet 1.10 and 1.54
Mild positive: bet 1.55 and 3.09
High positive: above 3.10)
Chlamydia IgG Antibody: 0.92 (Negative: less than 0.90
Equivocal: bet 0.91 and 1.09
Low Positive: bet 1.10 and 1.58
Mild Positive: bet 1.59 and 3.87
High Positive: above 3.88)
Best Regards
Thank you very much for your advice. I would like to provide further information and seek clarification:
(1)The lab ( a commercial lab in Singapore) was not able to tell me what test was done. I believe it is Herpes select as the results are indicated as follows;
HSV Type IgG Antibody 1.54 (Ref range: Negative: less than 90
Equivocal: between 0.91 and1.09
low positive: 1.10 and 1.54
Mid positive: 1.55 and 3.09
High Positive:more than 3.1)
HSV Type IgG Antibody 3.12 (Neg: Below:0.9,
Equivocal: bet 0.91 and 1.09
low positive: 1.10 and1.58
mild positive: 1.59 and 3.87
high positive; above 3.88)
I also did a Chlamydia IgG Antibody which shows a result of 0.92
which is within the Equivocal range for that test.
(2)My wife was 28 when she contracted chickpox.
(3)My hypothetical question is: if my wife contracts Type II orally from me, and her body produces antibody against the infection. Would she be protected from Type II genital herpes, assuming the contact happens after antibody has been produced.
Best Regards.
MEDICAL PROFESSIONAL
You don't say what test was used. If not the HerpeSelect test, you cannot reliably know you have HSV-2. In fact, the main problem with other HSV blood tests is a high frequency of false-positive HSV-2 results in people infected with HSV-1. Check with the provider who did the test, and ask for the proper one if not done.
1. That pain pattern does not suggest herpes, particularly discomfort for several weeks that fluctuates during the day.
2. No. If you develop your first symptomatic genital herpes outbreak in the future, the symptoms will be mild, like a typical recurrence, not like a typical primary infection.
3. Severe symptoms with one herpes group virus (varicella zoster, chickenpox) does not predict unusual severity for other herpes infections. If your wife was an adult when she acquired chickenpox, severe symptoms were typical; chickenpox almost always is more severe in adults than kids.
4. Your wife is unlikely to get HSV-2 orally from you; if she is at risk, it will be primarily through genital intercourse. Regardless of the site(s) exposed, prior chickenpox provides no protection against HSV of either type.
5. Most people set their own patterns for herpes recurrences in the first year or so after infection. It would be unusual for you to start having noticeable outbreaks at a frequency of, say, 3-4 times a year. However, less is known about asymptomatic viral shedding. All people with confirmed HSV-2 infection need to assume they have asymptomatic shedding from time to time, at which times they are infectious for their sex partners--at least for the first several years after infection.
6. Over time, recurrences tend to become less common. It is likely, but not well studied, that asymptomatic viral shedding also declines with time. But the time frame is several years, not just a few months or a couple of years. But nobody's immune system ever truly cures the infection. Once a person has HSV-2, the virus is believed to persist for life.
7. To my knowledge, there are no drugs in the research pipeline that are likely to truly eradicate HSV infection, and none that are likely to be any better than the current onces (acyclovir, valacyclovir, famciclovir) in controlling symptoms or reducing asymptomatic shedding.
Good luck-- HHH, MD
1. That pain pattern does not suggest herpes, particularly discomfort for several weeks that fluctuates during the day.
2. No. If you develop your first symptomatic genital herpes outbreak in the future, the symptoms will be mild, like a typical recurrence, not like a typical primary infection.
3. Severe symptoms with one herpes group virus (varicella zoster, chickenpox) does not predict unusual severity for other herpes infections. If your wife was an adult when she acquired chickenpox, severe symptoms were typical; chickenpox almost always is more severe in adults than kids.
4. Your wife is unlikely to get HSV-2 orally from you; if she is at risk, it will be primarily through genital intercourse. Regardless of the site(s) exposed, prior chickenpox provides no protection against HSV of either type.
5. Most people set their own patterns for herpes recurrences in the first year or so after infection. It would be unusual for you to start having noticeable outbreaks at a frequency of, say, 3-4 times a year. However, less is known about asymptomatic viral shedding. All people with confirmed HSV-2 infection need to assume they have asymptomatic shedding from time to time, at which times they are infectious for their sex partners--at least for the first several years after infection.
6. Over time, recurrences tend to become less common. It is likely, but not well studied, that asymptomatic viral shedding also declines with time. But the time frame is several years, not just a few months or a couple of years. But nobody's immune system ever truly cures the infection. Once a person has HSV-2, the virus is believed to persist for life.
7. To my knowledge, there are no drugs in the research pipeline that are likely to truly eradicate HSV infection, and none that are likely to be any better than the current onces (acyclovir, valacyclovir, famciclovir) in controlling symptoms or reducing asymptomatic shedding.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
