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Herpes in 4 year Monogamous Relationship
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Herpes in 4 year Monogamous Relationship

I have been in a monogamous relationship for 4 years and have a new herpes outbreak and am trying to understand the disease.

I have had several partners in the past but have never had any herpes symptoms. My current girlfriend's history is that she was in a 2-year relationship with a herpes type II positive partner 15 years ago, then in a 7-year monogamous relationship and is now in a 4-year monogamous relationship with me. She had 2 babies from the 2nd relationship mentioned. That partner has not experienced herpes symptoms. My girlfriend never thought she had herpes but was not tested. The doctors were aware of her previous herpes + partner when she gave birth but didn't see any symptoms.

On Jan 3rd and 4th, my GF and I had sex for the first times in 2 weeks. She mentioned having 6-9 ingrown hairs that night from her last waxing. On Jan 9th, I had itching on the left side of my penis & discovered a cluster of blisters. Jan 10th, blisters increased so I set an appointment at UW Medical Clinic. I had a swollen gland on the left side of my groin, was tired and achy. The PA diagnosed Herpes and did a culture test which came back + for Type II. I did a IgG, Type Specific Antibody (HerpeSelect®) test at Quest diagnostics that came back + for type I and neg. for type II
Type I results Out of range = 2.91
Reference <0.90

Type II results In Range <0.90
Out of Range (blank)
Reference <0.90

My GF had a blood test that was negative to Type I and + to Type II. Her doctor said she was not satisfied with the results and prescribed a western blot.
1) should my GF have the western blot test?
2) can I conclude decisively that my type II infection is new, from my current GF and not from one of MY past relationships?
3) is it plausible that she could have had the infection throughout our relationship but I am only just now getting infected -- 4 years into the relationship with sex on average of at least twice per week.
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You have been to an excellent clinic and from what you write, they seem to have provided you with excellent information.  To address your questions:

1.  I would think not.  the absence of symptoms is not a reason to doubt the HerpeSelect.  About 9 out of 10 Americans with genital herpes have not had symptoms.
2.  That would be my conclusion.
3.  Absolutely.  Transmission of HSV is a numbers game. You were not exposed to herpes every time you had sex since she was not asymptomatically shedding the virus all of the time.  When exposed to a partner with asymptomatic shedding, not every exposure results in infection. Over time your risk of acquisition accumulated until transmission occurred.

Hope this helps.  The good news is that you both have HSV-2 and are aware of it.  No risk of transmission.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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