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Virgin with Positive HSV-2
My boyfriend has never had oral or vaginal sex, and I know this is true. He took the Herpes Select test just as a precaution and found out he is positive for HSV-2. He has never had any symptoms. The IgM number was very low (around a 0.3) so the doctor said he has not had an outbreak recently and must have contracted the disease earlier on. His IgG number was 2.8. He had kissed three girls, only on the mouth, previous to myself when he was in high school. I also have never been sexually active, but since we have been kissing for two years, I was tested after this occurrence. I had found that I showed a recent exposure to HSV-1 but was negative for HSV-2. He retook the test recently and once again came out with a low IgM number and an IgG number of 2.99. How can this be?
1. What does the scale go up to?
2. I know you have written previously that anything under 3.5 is questionable. So would 2.99 still be considered low?
3. Do you think this is a false positive?
4. If not, since he has never had sexual activity, the only way he could have gotten it is if one of the girls herself had gotten oral HSV-2 from previous sexual activity and he contracted that from her by kissing her on the mouth. Again, I know that he has never had any sexual activity and has only kissed girls on their mouths. How possible is that?
5. We called the clinics in the area and no one offers the Western Blot or Biokit Rapid tests. Do you think that he should get those, or should we just forget these tests ever happened since they are most likely false positives? If he should get the tests, how do we go about finding them?
6. After the tests we taken, I read that since he has never been sexually active this test should have never been taken due to the possibility of false positives. Can I feel reassured that this is a false positive and cannot have been contracted from just kissing?
Thank you VERY much for your time.
1. What does the scale go up to?
2. I know you have written previously that anything under 3.5 is questionable. So would 2.99 still be considered low?
3. Do you think this is a false positive?
4. If not, since he has never had sexual activity, the only way he could have gotten it is if one of the girls herself had gotten oral HSV-2 from previous sexual activity and he contracted that from her by kissing her on the mouth. Again, I know that he has never had any sexual activity and has only kissed girls on their mouths. How possible is that?
5. We called the clinics in the area and no one offers the Western Blot or Biokit Rapid tests. Do you think that he should get those, or should we just forget these tests ever happened since they are most likely false positives? If he should get the tests, how do we go about finding them?
6. After the tests we taken, I read that since he has never been sexually active this test should have never been taken due to the possibility of false positives. Can I feel reassured that this is a false positive and cannot have been contracted from just kissing?
Thank you VERY much for your time.
As an FYI the Chicago Skin Clinic - 5440 W Belmont Ave, Chicago, IL - (773) 286-8111 performs the HSV2 Bio KITUSA test. Call them setup an appointment and the Dr. will go through all details with you. The result is available in a few minutes. Also see the abstract on the BioKit USA website. It documents a study on the value of using the BioKit to confirm HSV2 Focus testing.
MEDICAL PROFESSIONAL
brookdale. If you want no risk, do not sexually interact with other people. That is the only no risk activity. On the other hand, there are ways to make STD risk close to zero and they are discussed regularly on this site. If you don't want STDs, don't have sex. If you don't want to get hit by a car, don't cross the street. And if you don't want to be hit by lightening, go get in a cave and stay there. Of course that is not a very desirable way to live, is it?
As for your comment that I mentioned non-sexual activity transmitting herpes, you are wrong. You apparently have a very constrained definition of sex - sex does not require penetration. If you think it does, I think you must have a very boring sex life. Foreplay is sex. Please no more semantic quibbling. If you want to quibble about this, please take it somewhere else. EWH
As for your comment that I mentioned non-sexual activity transmitting herpes, you are wrong. You apparently have a very constrained definition of sex - sex does not require penetration. If you think it does, I think you must have a very boring sex life. Foreplay is sex. Please no more semantic quibbling. If you want to quibble about this, please take it somewhere else. EWH
I understand the obvious educational value of these forums. What makes me nervous is
the qualitiative assessments that could lead to persons obtaining STDs.
For example, both doctors express this almost zero, never seen, extremely low risk from hand contact (i.e. massage) causing herpes. But your last post clearly states this is a risk. Is is the same as getting struck by lightening? or is erotic massage a true risk? In fact your last post is the first mention that clinicians indeed have observed herpes from NON-SEXUAL activity?
the qualitiative assessments that could lead to persons obtaining STDs.
For example, both doctors express this almost zero, never seen, extremely low risk from hand contact (i.e. massage) causing herpes. But your last post clearly states this is a risk. Is is the same as getting struck by lightening? or is erotic massage a true risk? In fact your last post is the first mention that clinicians indeed have observed herpes from NON-SEXUAL activity?
MEDICAL PROFESSIONAL
1. There is a theoretical possibility that, if someone had a herpes lesion on their genitals and were rubbing themselves (i.e. foreplay) against his body, transmission could occur. Clinicians occasionally see herpes inoculated onto persons' thighs, buttocks or lower abdomen in this way. They are diagnosed because lesions then occur on the buttocks, thighs or lower abdomen and are cultured. This is very, very uncommon but it is a way that someone could get HSV-2 without oral or genital sex.
2. The HerpeSelect is based on the reaction of antibodies with a number of herpes antigens (proteins) which are used in the test. If there is a cross reaction with one of those antigens, false positives can occur. In a true positive, the antibodies react with multiple antigens. Unlike in the HerpeSelect, in the Western blot those performing the test can see exactly which antigens are reactive. If it is a single antigen, it is a false positive. If it reacts with multiple antigens, it is a true positive. This test is more complex and costly than the HerpeSelect but it is a good way to sort out false positives (which are rare with higher values) from true positves.
3. AS I mentioned earlier, I suspect you can find out where to get the Western blot ordered and sent to the University of Washington through either the ASHA web site or hot line or the MedHelp Herpes Forum.
4. As I told you- this is a decision you must make and that I cannot make for you. I strongly suspect this is a false positive. If you choose to pursue it further, that is your decision but in considering that, I would urge you to consider what you would do with the information you get from further testing. Given your commitment to him I would hope it would not change things between you. EWH
2. The HerpeSelect is based on the reaction of antibodies with a number of herpes antigens (proteins) which are used in the test. If there is a cross reaction with one of those antigens, false positives can occur. In a true positive, the antibodies react with multiple antigens. Unlike in the HerpeSelect, in the Western blot those performing the test can see exactly which antigens are reactive. If it is a single antigen, it is a false positive. If it reacts with multiple antigens, it is a true positive. This test is more complex and costly than the HerpeSelect but it is a good way to sort out false positives (which are rare with higher values) from true positves.
3. AS I mentioned earlier, I suspect you can find out where to get the Western blot ordered and sent to the University of Washington through either the ASHA web site or hot line or the MedHelp Herpes Forum.
4. As I told you- this is a decision you must make and that I cannot make for you. I strongly suspect this is a false positive. If you choose to pursue it further, that is your decision but in considering that, I would urge you to consider what you would do with the information you get from further testing. Given your commitment to him I would hope it would not change things between you. EWH
Thank you for your helpful response. Just a few follow up questions:
1. I know that he has never had sexual activity or genital-genital or genital-mouth contact, so the test must be a false positive since those are the only ways to get HSV-2, right?
2. However, since the number is close to 3, there must be mistakes or cross references with antibodies. How will the Western Blot be able to be more accurate, and not have the same errors as the Herpes Select tests? Couldn't the same errors occur?
3. Chicago would be the easiest city to access. Do you know of any clinics in the Chicagoland area that would be able to send out to be tested for it because we have had difficulty trying to find one?
4. I know I asked previously, but for peace of mind: even though the number is close to 3, can we confidently believe this is a false positive based on having no activity? Do you think the Western Blot is worth finding or now just have faith it could not have been contracted? I am concerned because I want to marry this man and have a normal and worry-free sex life since we have both have waited for that time.
Thank you SO much for your answers because it is hard to find someone knowledgeable since this is such a confusing and emotional issue.
1. I know that he has never had sexual activity or genital-genital or genital-mouth contact, so the test must be a false positive since those are the only ways to get HSV-2, right?
2. However, since the number is close to 3, there must be mistakes or cross references with antibodies. How will the Western Blot be able to be more accurate, and not have the same errors as the Herpes Select tests? Couldn't the same errors occur?
3. Chicago would be the easiest city to access. Do you know of any clinics in the Chicagoland area that would be able to send out to be tested for it because we have had difficulty trying to find one?
4. I know I asked previously, but for peace of mind: even though the number is close to 3, can we confidently believe this is a false positive based on having no activity? Do you think the Western Blot is worth finding or now just have faith it could not have been contracted? I am concerned because I want to marry this man and have a normal and worry-free sex life since we have both have waited for that time.
Thank you SO much for your answers because it is hard to find someone knowledgeable since this is such a confusing and emotional issue.
MEDICAL PROFESSIONAL
The exchanges on this forum are made public for their educational value to those who wish to view them. The exchange however is between the doctors and those who have asked (and paid for) the questions. When others have comments, in general, they are left for others to consider and learn from. The exception to that is when others ask questions which, because they are based on out of context statements and comments will only provoke unnecessary anxiety and mis-understanding. Such posts will be deleted without comment. EWH
MEDICAL PROFESSIONAL
Dr. Handsfield and I share the forum and whoever picks up the question answers it. You got me. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
You've obviously done a good job of looking into the issues surrounding testing for HSV so I suspect much of what you are about to hear will be review. From your description (I can't help but wonder why you have written and not him however) and without a history of sex of any kind and no lesions, he is very low risk, making it quite likely that this result is a false positive. You can take that for what it is worth (a well educated guess) or you can pursue the issue further. If you choose to pursue it, the Western Blot would probably tell you more than the Biokit although it may be easier to find someone who does the Biokit wherever it is that you live.
HerpeSelect results become more meaningful as the value gets higher. The company has set their criterion for a positive test at 0.9 and the FDA accepted it, this will not change. Research since the test has become available indicates that persons with values close to 0.9 are often false positive and that as the numerical value increases, so does the likelihood of the result representing true infection. Virtually all results over 3.0 or 3.5 are representative of true infections but as in all of science if there were going to be an exception (and there are), the situation you describe is the sort of situation in which it would occur. There are people with values over 3.0 that have proven to be false positive results.
Regarding the IgM result- a positive is useless information - too many false positives and cross reactions. It does not help sort this situation out in any way. As for your questions:
1. I'm not sure. We regularly see people with values above 5.0. the scale is not linear however.
2. See my comment above. This is not an all or nothing situation. Rather, the higher above 0.9, the greater the probability it represents a true positive. His values are in the range where false positives become less common.
3. Again, see above. If the history you provided is correct it certainly could be. Please aware that there does not have to be sexual penetration to transmit herpes, just contact with another person’s body when they are shedding the virus and bad luck.
4. HSV-2 is very rare in the mouth and when it is present there this is very uncommon. For another uncommon possibility see 3 above. Whatever is going on here is not a "typical" situation.
5. If it were me, I would forget that this ever happened. You have to make your own decision as I'm sure you will. If you wish to get a Western Blot of Biokit assay, I'd seek advice either at MedHelp's Herpes Community (link is on the right margin of this answer) or at the American Social Health web sire or hotline ((disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA)
6. This is repeat of your earlier questions, just rephrased. I suspect this is a false positive.
Hope this helps. EWH
You've obviously done a good job of looking into the issues surrounding testing for HSV so I suspect much of what you are about to hear will be review. From your description (I can't help but wonder why you have written and not him however) and without a history of sex of any kind and no lesions, he is very low risk, making it quite likely that this result is a false positive. You can take that for what it is worth (a well educated guess) or you can pursue the issue further. If you choose to pursue it, the Western Blot would probably tell you more than the Biokit although it may be easier to find someone who does the Biokit wherever it is that you live.
HerpeSelect results become more meaningful as the value gets higher. The company has set their criterion for a positive test at 0.9 and the FDA accepted it, this will not change. Research since the test has become available indicates that persons with values close to 0.9 are often false positive and that as the numerical value increases, so does the likelihood of the result representing true infection. Virtually all results over 3.0 or 3.5 are representative of true infections but as in all of science if there were going to be an exception (and there are), the situation you describe is the sort of situation in which it would occur. There are people with values over 3.0 that have proven to be false positive results.
Regarding the IgM result- a positive is useless information - too many false positives and cross reactions. It does not help sort this situation out in any way. As for your questions:
1. I'm not sure. We regularly see people with values above 5.0. the scale is not linear however.
2. See my comment above. This is not an all or nothing situation. Rather, the higher above 0.9, the greater the probability it represents a true positive. His values are in the range where false positives become less common.
3. Again, see above. If the history you provided is correct it certainly could be. Please aware that there does not have to be sexual penetration to transmit herpes, just contact with another person’s body when they are shedding the virus and bad luck.
4. HSV-2 is very rare in the mouth and when it is present there this is very uncommon. For another uncommon possibility see 3 above. Whatever is going on here is not a "typical" situation.
5. If it were me, I would forget that this ever happened. You have to make your own decision as I'm sure you will. If you wish to get a Western Blot of Biokit assay, I'd seek advice either at MedHelp's Herpes Community (link is on the right margin of this answer) or at the American Social Health web sire or hotline ((disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA)
6. This is repeat of your earlier questions, just rephrased. I suspect this is a false positive.
Hope this helps. EWH
I am sorry I forgot to mention that I was addressing this to Dr. Handsfield since I have read many of his posts on the Western Blot and Herpes. Dr. Hook, I thank you for any comments in addition to Dr. Handsfield's.
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.
