Is there a test I can take to see if I have a new or an old HSV-2 infection?

[texmex5445]

7 weeks ago, I got drunk and received unprotected (no condom) oral sex and wore a condom for vaginal sex. My first time cheating in16 years. I was never tested for STD’s before, I panicked and got tested 6-7 weeks after the incident. I got my results yesterday, I was clear of all STD’s except for HSV-2.

Test Name HSVII Ab IGG RES   HSVII IGG Interp   Method EIA
Out Of Range  9.95 H POSITIVE     Normal Range <0.99 NEGATIVE

Is this an old, well established 16year old infection or a new 7 week old infection? Is there a chance of a false positive? (9.95 seems like a really high number) Can I get HSV-2 from receiving unprotected oral sex, and wearing a condom during vaginal sex? In 16 years to this day I never had an outbreak on my genitals EVER and neither has my wife. 3 weeks ago I had one round white head pimple on my left buttox close to my leg. I tried to pop it, put some acne medicine on it and it went away in one week. Occasionally I have some inflammation around my anus, I put some hemorrhoid cream on it and it goes away in one day. My wife got tested for all types of STD’s 7 years ago, as she had a very painful UTC, and I think she got tested again 5 years ago when we had twins. I am positive she doesn’t sleep around. Is it possible for me to have had HSV-2 for over 16years with no outbreaks and not to pass it to my wife? (we have unprotected sex around 2 times a month). Is there a test I can take to see if this is a new or an old infection? Does the number 9.95 suggest an old infection? If my wife has no symptoms or outbreaks what are the chances of her having HSV-2? If this is a new infection, I will have to tell my wife and this will devastate her and certainly end our marriage. If this is an old infection I got before we were married and she never got infected from me, them maybe I should just keep quiet and live with the guilt. I check myself over and over and still no sores anywhere! PLEASE HELP ME!

[texmex5445]

Thank You for the feedback, my wife worried about the twins but now she understands more about how HSV spreads and is calming down a bit.

I was told that IGM levels can indicate if the infection is recent or old.
Since the questionable incident happened only a few months back, and it is important for me to find out if I got infected then or many years ago without even knowing it, I took an IGG IGM test since I was told that the presence of IGM may indicate a recent infection.

Of course I got the results and I have no idea what they mean.

Test Name          In Range      Out Of Range      Reference Range

IGG, SERUM         982                                     694 - 1618 mg/dL
IGM, SERUM         93                                         48 - 271  mg/dL

What do these levels mean?
I see 93 for IGM, does this indicate a recent infection?

Please help!

Tex

[Edward W Hook, MD]

When people acquire herpes they may have mild symptoms which can be mis-identified as iirritation due to other casues (chaffing, etc).  As you point out, there is no way to know how HSV entered your life and you will probably not know.  I douby that it was due to your exposure two months ago.  On the other hand, you both have it so there is no reason to worry about transmission between the two of you.  As for yor kids, I would not worry.  HSV is transmitted only by DIRECT contact so that unless there is genital contact withthe children (and there should not be), transmission is not a concnern.  EWH

[texmex5445]

UPDATE:
I bit the bullet and told my wife that I had blood-work done because of a small rash and the test came back positive for herpes. Obviously she was very upset, got tested as well, and came back positive for HSV-2. She was told by her doctor that since she had no outbrakes that had noticed thus far, that she may never experience one, and that made her feel better. The question about how did HSV-2 enter our lives still remains.
As I was told that my stupid Bachelor's party adventure may have nothing to do with HSV-2, I selfishly choose not to add to our family problems by admitting to it. My wife is mostly worried about our twins and how to keep them from getting infected. Thank you all for the advise and valuable information I got on this board.

[Edward W Hook, MD]

You are asking great questions whic, unfortunately, there are no completely satisfactory answers.  It certainly is more likely than not that your wife has been infected by now and if she has not been, that she will not be.  Can I promise you this however- no.  Sorry I can be more precise but it is just not possible.  EWH

[texmex5445]

Thank you for the response.
Besides the incident that happened 7 weeks ago, I have no other ways I could have gotten infected thinking back 20 years! And I have never gotten any unusual outbrakes or rashes anywere on my body as long as I can remember either. My wife of 16 years never had any outbrakes or rashes as well. Are there any chances that she is not infected after 16 years of unprotected sex? And if she is not infected by now, what are the chances she will get HSV-2 from me in the future?

[Edward W Hook, MD]

Welcome to our Forum.  Your test result is in the range in which it is virtually certain that you do have HSV-2.  The test result does not tell you how long you have had the infection.  While I cannot promise you, I suspect that you have had HSV-2 for a long time an did not acquire it from the activity that you describe.. This infection is VERY rarely transmitted by oral sex (unlike HSV-1) and if you had become infected you should have experienced an outbreak.

To put this into perspective, about 20% of adult Americans have HSV-2 and of those who have the infection, about 90% do not know it.  Conventional wisdom is that the way that this happens is that people have HSV infections in which their symptoms are rather mild and are attributed to some other cause. Because herpes infections then resolve by themselves, people are unaware of their infection.  About 10% of people with genital HSV do not have further recurrences.  In addition, I certainly have had a number of patients in whom infection has been present for long periods of time without transmission occurring.

So, what can you do. there is a chance that your wife, like you has HSV and is unaware of it.  The best way to determine if this is the case is for her to be tested with the same test you were tested with.  If she is positive, you have been both infected for some time and there is no way to know who gave it to whom or whether you both were infected before you met.  If you are both infected it is also irrelevant since then you cannot give infection to each other.  On the other hand, if she is not infected, transmission could occur.

I hope these comments are helpful.  EWH