Recently diagnosed with HSV2.. Please help!!

[smithw]

Hi!!
Recently I was diagnosed with HSV2. My first Igg test was 1.8 and my second Igg test was 1.4. I never had any symptoms and my partner of many years in negative.

1) What do low Igg test scores mean? I see many people have high scores such as 3.5, 6.5 or 9. What is the difference between 6.5 score and 1.4 score?
2) Should I re-test since my scores are low, my partner of many years in negative and since I do not have any symptoms?
3) Since I do not have any symptoms nor ant discomfort should I consult with a doctor?
4) Should I start using Valtrex or similar drug in order to protect my negative partner?
5) Does HSV2 virus get worst or better with the time?
6) Can levels of virus increase or decrease with the time?

All of your help is appreciated.


Thanks
SW

[H. Hunter Handsfield, M.D.]

It would be useful to know your HSV-1 blood test result.  Half the population has positive results for HSV-1.  In those people, HSV-2 results like yours often are falsely positive.  In other words, it is possible you don't have HSV-2 at all.  However, if your HSV-1 result was negative, then you are indeed infected with HSV-2.

1) See above about low test results.  Otherwise, the OD ratio figure means nothing:  people with results of say 2.0, 3.5, or 6 have equal frequencies of outbreaks, asymptomatic viral shedding, etc.

2) If your HSV-1 result is positive, you should have a confirmatory test for HSV-2.  You could be re-tested with a different test, such as the BiokitUSA test.  Or have your lab send a specimen to the University of Washington clinical laboratory in Seattle for a Western blot test--the ultimate gold standard for HSV antibody testing.

Your other questions don't matter unless your HSV-2 infection is confirmed.  Asymptomatic HSV-2 infected people get no benfit from antiviral therapy.  The risk of transmission would be reduced, but your transmission risk might low anyway, since you haven't yet transmitted HSV-2 to your partner.  In general, the frequency of viral shedding and symptomatic outbreaks diminishes over several years.

For now, you and your partner might use condoms to reduce the already low risk of transmission; then address all these issues once it is clear whether you are or are not infected with HSV-2.  For more details about HSV testing and the relationship between HSV-1 and HSV-2 results, use the search link to look for 'HerpeSelect test' and 'herpes diagnosis'; you will find many discussions.

Good luck--  HHH, MD

[smithw]

Thanks..

I am HSV1 negative (one test lab corp). That is at least what test stated. I tested twice for HSV2 with Labcorp and both times my tests were positive, 1.8 and 1.4. I guess I am infected but I never had any outbreaks nor I ever infected my girlfriend who tested negative for HSV1 and HSV2.

Based on our discussion how serious is my situation? Do you think I will  have a problem to make children? For now we are strictly using condoms and our sex life is definitelly not what it used to be but we are working on it. In the future we will have to have sex without condom if we are to have children. How can we lower risk of transmition if we proceed to have sex without condoms? Is there any antiviral cream or something similar in addition to Valtrex..?

Thanks
Smithw  

[H. Hunter Handsfield, M.D.]

So you definitely have HSV-2.  I cannot judge the risk of transmission without a lot more information that you don't provide and probably don't know:  how long you might have been infected, whether you might be having mild symptoms you haven't noticed, and so on.  But probably the risk is low.  In monogmous couples in which one person has HSV-2, who have sex 2-3 times per week, transmission occurs in only about 5% of couples per year.  So the risk for any particular sexual event obviously is low, and you might go a whole lifetime of regular sex and never infect your partner.

Herpes never gets in the way of having kids.  Most couples in your situation just cease using condoms when they want to conceive, at least during mid-cycle.  Other couples decide to just not worry about it:  if your partner isn't likely to be dating other people, i.e. there is no risk of transmission to someone else, what does it matter if she gets infected?  Most cases are mild or asymptomatic, and medication can control symptoms if they are bothersome.  (But one extremely important exception to this:  If your partner becomes pregnant and has not had herpes, you must avoid all genital sex during the last 3 months of her pregnancy.  If she gets infected late in pregnancy, there is great danger to the baby.)

There are no creams that help herpes.  Valtrex or other antiviral drugs can reduce the risk of transmission to your partner, but as I suggested already, that risk might be too low to worry about.  Consult your own health care provider about treatment.

Your questions show you know little about herpes.  You need to get the information in much more detail than is practical on a forum like this.  A number of website are excellent sources, such as CDC (www.cdc.gov/std), the Amercian Social Health Association (www.ashastd.org), Public Health - Seattle & King County (www.metrokc.gov/health/apu/std), and the Westover Heights Clinic of Portland, OR (www.westoverheights.com).  Also consider phoning ASHA to use their in-person counseling service, which is excellent.

[smithw]

I know a little. Have been reading ever since I gor + result..
Thanks a lot
Smithw

[gracefromHHP]

I think I suggested this before over on the patient board but why not just retest with one of the confirmatory tests that HHH mentioned just for peace of mind?  Sure sounds worth it to me.

grace

[ryred12]

wald study of discord couples suggest that if one uses condom and once daily valtrex over an 8 month period there is only a  0.4 percent chance of transmission.  Terri Warren Herpes experts states in in one year for a women once daily valtrex and condom about 2% for a women and about 1 percent for man rates of transmission.  If your partner is female and is negative for HSV 1 there is a study going on for a herpes vaccine herpvac I like to call it herpes insurance.  It will protect the women up to 40 %  will never obtain the virus and 75% will either never obtain herpes or never have an outbreak if contracted.  55% of the US population has HSV1 according to new study.  Also valtrex has been shown to be slightly more effective than famvir with Valtrex on average one sheds only 1.3 percent of days (daily suppresion) Famvir is 2.8% percent of days.  herpvac is three shots i believe much like gardisil 3 shots over a 5 or 6 month period.  

[smithw]

Does this apply for HSV1 and HSV2?  "40 % will never obtain the virus and 75% will either never obtain herpes or never have an outbreak if contracted."

Thanks
smithw

[rickity]

I have had no luck getting any reliable and up to date information on the FDA approval of any HSV2 vaccine?  Not from the CDC or any vaccine website, what is the status and how could one go about getting the vaccine?

[H. Hunter Handsfield, M.D.]

There is no available, effective vaccine against HSV-2. There is one in clinical trials, but its at least a couple years away from FDA approval for marketing in the US.  And presliminary data suggest it is only marginally effective anyway, and probably will have no benefit for anybody already infected with HSV-1 (i.e., half the US population).  

[jedispider]

im sorry i didnt mean to over post anything its because the forum is fulll and i cant post a question, i dont mean to be annoying but i just want to know what the risks are if i there was semen on the vagina of  a massuse and she wiped it off with a towel, please and im sorry i was annoying. thank you doctor

[monkeyflower]

This isn't a pregnancy forum. Post on the women's forum. They get questions like this all the time.

I considered answering you the first time I saw your post, because I assumed from the nature of the question that you and your partner were both very young. But you're talking about a sex worker. Jesus, this should be the very last thing you worry about. She should know enough about her body and be together enough to be on the pill/using emergency contraception/avoiding pregnancy on her own. This isn't your responsibility.

[jedispider]

thanks alot for your help i just felt really guilty for going to that place ill never go back there after this