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When Did I get genital herpes
I recently had an std panel done and my nurse practioner advised me to go ahead and get an hsv-2 test. the igg antibody one. So I went ahead and did the test and it came back positive with my number at 1.49. The bothersome part for me is that I have only been with my husband in the last six years. I wondering if this means he gave it to me recently.
The background information you may need is that my husband has been out of the country for the last 16 months and has only been home twice.
His last visit I noticed a pimple on my vaginal lip area not near the hair and asked him about it and he said no big deal. Well it went away and then two weeks after he left I had another almost in the same place. Now while he hasn't been tested yet because he is not close to a facility that he can I am curious to wonder if he has cheated. Another piece of information you will need to know is that I have researching this very much and found on a medical website that if my numbers were below 3.5 then I had a recent infection. I have also found that you will have your first reaction to hsv2 within the first 2 to 10 days. I am very concerned if my number means that it is recent. You may need to know that prior to my husband I had two partners. but they were six years ago and my husband prior to me has had five partners. Is this something that could have laid dormant in him for the last six years and he just recently infected me with an old infection? Thanks for your time
The background information you may need is that my husband has been out of the country for the last 16 months and has only been home twice.
His last visit I noticed a pimple on my vaginal lip area not near the hair and asked him about it and he said no big deal. Well it went away and then two weeks after he left I had another almost in the same place. Now while he hasn't been tested yet because he is not close to a facility that he can I am curious to wonder if he has cheated. Another piece of information you will need to know is that I have researching this very much and found on a medical website that if my numbers were below 3.5 then I had a recent infection. I have also found that you will have your first reaction to hsv2 within the first 2 to 10 days. I am very concerned if my number means that it is recent. You may need to know that prior to my husband I had two partners. but they were six years ago and my husband prior to me has had five partners. Is this something that could have laid dormant in him for the last six years and he just recently infected me with an old infection? Thanks for your time
MEDICAL PROFESSIONAL
It is unlikely you have HSV-2 at all. You can use the search link to find many discussions on this forum about interpreting the HSV-2 antibody testa. For a recent example of a case similar to yours, see this thread: http://www.medhelp.org/posts/show/581379. ;(As you will see, it sorted out for that person exactly as I predict it will work out for you.)
The main point is that although the official recommendation from the test producer is that any ELISA ratio over 1.1 is positive, more recent research shows that only levels of 3.5 and higher are reliably positive. The higher the value toward 3.5, the more likely an accurate result. Only about 10-20% of people with values around 1.5 are actually infected. When that fact is combined with your obvious low risk for genital herpes, it is unlikely that your result is truly positive. It is not exactly true that low positive levels suggest early infection. That's a possibility, but it is more likely it's just a false positive result. Even if your result turns out to be truly positive, it is still more likely you have a longstanding infection, not a new one. The only wrinkle in your case is the genital pimple, which could be consistent with herpes. But most pimples and most herpes lesions really don't look the same to a trained provider, and your doctor's reassurance about the lesion probably was correct.
As you can find in other threads, this can be sorted out with repeat testing. One option is to ask your doctor to do a BiokitUSA HSV-2 blood test (which is performed in the office in 20 minutes). Even if your doc doesn't routinely provide the test, he can order a test kit from a local supplier and then test you. Research has demonstrated that the Biokit test is an excellent tie-breaker for low-positive results like yours.
Alternatively, you could ask your doctor to send blood for an HSV Western blot test, which is done at the University of Washington laboratory in Seattle (where the WB was developed and much of the research on HSV blood tets). It costs more than Biokit (perhaps $200 or more) and might not be covered by insurance, but WB is the gold standard in sorting out uncertain situations like this.
I hope this helps. When all is said and done, most likely you will find you don't have HSV-2, so don't be too worried as you wait for repeat test results.
Good luck-- HHH, MD
The main point is that although the official recommendation from the test producer is that any ELISA ratio over 1.1 is positive, more recent research shows that only levels of 3.5 and higher are reliably positive. The higher the value toward 3.5, the more likely an accurate result. Only about 10-20% of people with values around 1.5 are actually infected. When that fact is combined with your obvious low risk for genital herpes, it is unlikely that your result is truly positive. It is not exactly true that low positive levels suggest early infection. That's a possibility, but it is more likely it's just a false positive result. Even if your result turns out to be truly positive, it is still more likely you have a longstanding infection, not a new one. The only wrinkle in your case is the genital pimple, which could be consistent with herpes. But most pimples and most herpes lesions really don't look the same to a trained provider, and your doctor's reassurance about the lesion probably was correct.
As you can find in other threads, this can be sorted out with repeat testing. One option is to ask your doctor to do a BiokitUSA HSV-2 blood test (which is performed in the office in 20 minutes). Even if your doc doesn't routinely provide the test, he can order a test kit from a local supplier and then test you. Research has demonstrated that the Biokit test is an excellent tie-breaker for low-positive results like yours.
Alternatively, you could ask your doctor to send blood for an HSV Western blot test, which is done at the University of Washington laboratory in Seattle (where the WB was developed and much of the research on HSV blood tets). It costs more than Biokit (perhaps $200 or more) and might not be covered by insurance, but WB is the gold standard in sorting out uncertain situations like this.
I hope this helps. When all is said and done, most likely you will find you don't have HSV-2, so don't be too worried as you wait for repeat test results.
Good luck-- HHH, MD
MEDICAL PROFESSIONAL
Grace is correct; if a pimple-like lesion reappears, see your provider ASAP, preferably within a day. But even then, although a positive test for HSV would nail down the diagnosis, a negative result still would leave things uncertain. A WB is more likely to sort this out sooner.
Also if your genital symptoms reoccur - see your provider within 24-48 hours for a lesion culture to check for hsv2 too. Might be easier than getting the WB or a biokit done.
grace
grace
Thank you so much for your comment. I will continue to research the threads you have suggested and will talk to my doctor about the western blot. Although it may be more expensive, I need to know for sure. Thank you for your help.
MEDICAL PROFESSIONAL
By the way, it is situations like yours that have led most STD experts to recommend against routine HSV-2 testing except in people at substantial risk for genital herpes, such as those with symptoms, those who are regular sex partners of people known to have HSV-2, and persons with especially high risk lifestyles, like multiple partners. This is a somewhat controversial issue, and I cannot criticize your NP for recommending you be tested, especially if she was aware of your genital "pimple" episode. But the lower the chance someone is infected, the higher the chance of confusing results like yours.
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.
